<form action="https://mailorbit-app-demo.templates.codememory.com/f/demo-form-workshop/submit" method="post" style="max-width:420px;font-family:sans-serif">
  <input type="email" name="email" placeholder="Your email" required style="display:block;width:100%;margin:0 0 10px;padding:10px;border:1px solid #ccc;border-radius:8px">
  <input type="text" name="firstName" placeholder="First name" style="display:block;width:100%;margin:0 0 10px;padding:10px;border:1px solid #ccc;border-radius:8px">
  <input type="text" name="city" placeholder="City" style="display:block;width:100%;margin:0 0 10px;padding:10px;border:1px solid #ccc;border-radius:8px">
  <input type="text" name="website" tabindex="-1" autocomplete="off" style="position:absolute;left:-9999px" aria-hidden="true">
  <label style="display:block;margin:0 0 10px;font-size:13px"><input type="checkbox" name="consent" value="yes" required> I agree to get emails from Bloom & Root</label>
  <button type="submit" style="width:100%;padding:12px;border:0;border-radius:999px;background:#2F5D3A;color:#fff;font-weight:700">Join the waitlist</button>
  <img src="https://mailorbit-app-demo.templates.codememory.com/f/demo-form-workshop/v" width="1" height="1" alt="" style="position:absolute">
</form>

Paste where the form should appear. It works without JavaScript; style it to match your site.