Modal Sign Up Sheet

My first entry into the DailyUI challenge. Trying to step up my design game by practicing the art a little more. Trying not to spend too much time on each piece, max an hour each, though this took a little shorter than that.

It's a simple sign up sheet for web, based on the design language of the dailyui.co website. I'm not completely satisfied with it, but hopefully I'll get better as I do more of them.

Happy to accept any and all feedback :)