{"id":1731,"date":"2021-04-21T22:23:37","date_gmt":"2021-04-21T20:23:37","guid":{"rendered":"https:\/\/prendrelere.be\/?page_id=1731"},"modified":"2021-04-26T11:03:38","modified_gmt":"2021-04-26T09:03:38","slug":"familles-stages-inscriptions","status":"publish","type":"page","link":"https:\/\/prendrelere.be\/index.php\/familles-stages-inscriptions\/","title":{"rendered":"Familles &#8211; Stages &#8211; Inscriptions"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1731\" class=\"elementor elementor-1731\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1666181 elementor-section-height-min-height elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"1666181\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c7cc975\" data-id=\"c7cc975\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-decb836 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"decb836\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-b9ffec6\" data-id=\"b9ffec6\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c1a7a62 elementor-widget elementor-widget-heading\" data-id=\"c1a7a62\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">familles<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dc73e86 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"dc73e86\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-62de456 elementor-widget elementor-widget-heading\" data-id=\"62de456\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Inscription stage<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-37084ac elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"37084ac\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-88d7328\" data-id=\"88d7328\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9df7db3 elementor-widget elementor-widget-heading\" data-id=\"9df7db3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Formulaire d'inscription <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-54b359d elementor-widget elementor-widget-text-editor\" data-id=\"54b359d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\"><span style=\"color: #ff0000;\"><strong>N&rsquo;oubliez pas de nous contacter pour savoir s&rsquo;il reste des places disponibles avant de compl\u00e9ter la fiche d&rsquo;inscription.<\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-df2e600 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"df2e600\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-2c5d92a\" data-id=\"2c5d92a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d8dbe76 elementor-widget elementor-widget-text-editor\" data-id=\"d8dbe76\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-1721\"><form id=\"wpforms-form-1721\" class=\"wpforms-validate wpforms-form\" data-formid=\"1721\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/1731\" data-token=\"c57956adace17580ab20f9cd81ee27e1\"><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1721-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_0\">Coordonn\u00e9es de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" placeholder=\"Nom\" required><label for=\"wpforms-1721-field_0\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-1721-field_0-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Nom<\/label><\/div><\/div><\/div><div id=\"wpforms-1721-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_2\">Date de naissance <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_2\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"9999-99-99\" name=\"wpforms[fields][2]\" placeholder=\"exemple : 2000-12-31\" required><\/div><div id=\"wpforms-1721-field_56-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_56\">Num\u00e9ro de registre national de l&#039;enfant  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_56\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][56]\" required><div class=\"wpforms-field-description\">Indispensable pour compl\u00e9ter l&rsquo;attestation fiscale<\/div><\/div><div id=\"wpforms-1721-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_4\">Adresse  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" placeholder=\"Adresse\" required><\/div><div id=\"wpforms-1721-field_6-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_6\">Stages de Printemps <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1721-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" required=\"required\"><option value=\"Harry Potter (7 \u00e0 12 ans)\" >Harry Potter (7 \u00e0 12 ans)<\/option><option value=\"A la d\u00e9couverte de nos sens (2,5 \u00e0 5 ans)\" >A la d\u00e9couverte de nos sens (2,5 \u00e0 5 ans)<\/option><option value=\"A la d\u00e9couverte de nos sens (6 \u00e0 8 ans)\" >A la d\u00e9couverte de nos sens (6 \u00e0 8 ans)<\/option><\/select><\/div><div id=\"wpforms-1721-field_9-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_9\">Personne responsable  <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_9\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][9][first]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-1721-field_9\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_9-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][9][last]\" placeholder=\"Nom\" required><label for=\"wpforms-1721-field_9-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Nom<\/label><\/div><\/div><\/div><div id=\"wpforms-1721-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_10\">Num\u00e9ro de t\u00e9l\u00e9phone  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" placeholder=\"Num\u00e9ro de t\u00e9l\u00e9phone \" required><\/div><div id=\"wpforms-1721-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_1\">E-mail <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1721-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" placeholder=\"Adresse mail\" spellcheck=\"false\" required><\/div><div id=\"wpforms-1721-field_43-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"43\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_43\">Lien de parent\u00e9 <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1721-field_43\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][43]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Lien de parent\u00e9<\/option><option value=\"M\u00e8re\" >M\u00e8re<\/option><option value=\"P\u00e8re\" >P\u00e8re<\/option><option value=\"Tuteur\" >Tuteur<\/option><\/select><\/div><div id=\"wpforms-1721-field_55-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"55\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_55\">Num\u00e9ro de registre national de la personne responsable <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_55\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][55]\" required><div class=\"wpforms-field-description\">Indispensable pour compl\u00e9ter l&rsquo;attestation fiscale\r\n<\/div><\/div><div id=\"wpforms-1721-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_17\">Personne \u00e0 contacter en cas d&#039;urgence (en plus de la personne responsable) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" placeholder=\"Nom Pr\u00e9nom\" required><\/div><div id=\"wpforms-1721-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_18\">Num\u00e9ro de t\u00e9l\u00e9phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_18\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][18]\" placeholder=\"Num\u00e9ro de t\u00e9l\u00e9phone \" required><\/div><div id=\"wpforms-1721-field_19-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"19\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_19\">Lien de parent\u00e9 <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1721-field_19\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][19]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Lien de parent\u00e9<\/option><option value=\"M\u00e8re\" >M\u00e8re<\/option><option value=\"P\u00e8re\" >P\u00e8re<\/option><option value=\"Papy-Mamy\" >Papy-Mamy<\/option><option value=\"Tuteur\" >Tuteur<\/option><\/select><\/div><div id=\"wpforms-1721-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_16\">Nom et coordonn\u00e9es du m\u00e9decin traitant de l\u2019enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" placeholder=\"Nom du m\u00e9decin traitant\" required><\/div><div id=\"wpforms-1721-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_20\">Num\u00e9ro de t\u00e9l\u00e9phone  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_20\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][20]\" placeholder=\"Num\u00e9ro de t\u00e9l\u00e9phone\" required><\/div><div id=\"wpforms-1721-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_21\">Adresse <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_21\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][21]\" placeholder=\"Adresse\" required><\/div><div id=\"wpforms-1721-field_22-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_22\">Y-a-t-il des remarques concernant la participation de l\u2019enfant \u00e0 certaines activit\u00e9s ? Oui &#8211; Non.  <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-1721-field_22\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][22]\" placeholder=\"Si oui, lesquelles :\" required><\/textarea><\/div><div id=\"wpforms-1721-field_25-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_25\">Renseignements m\u00e9dicaux concernant l&#039;enfant  <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1721-field_25\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][25]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Suit-il un traitement m\u00e9dical ?<\/option><option value=\"OUI\" >OUI<\/option><option value=\"NON\" >NON<\/option><\/select><div class=\"wpforms-field-description\">Si OUI, merci de joindre l\u2019ordonnance du m\u00e9decin traitant avec les m\u00e9dicaments correspondants. (Bo\u00eetes de\r\nm\u00e9dicaments dans leur emballage d\u2019origine, marqu\u00e9es au nom de l\u2019enfant et accompagn\u00e9es de leur notice.)\r\n! Nous vous rappelons qu\u2019aucun m\u00e9dicament ne pourra \u00eatre donn\u00e9 \u00e0 l\u2019enfant sans ordonnance ! \r\n<\/div><\/div><div id=\"wpforms-1721-field_49-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"49\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_49\">Lieu de naissance  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_49\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][49]\" placeholder=\"Lieu de naissance \" required><\/div><div id=\"wpforms-1721-field_50-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"50\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_50\">Groupe sanguin <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1721-field_50\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][50]\" placeholder=\"Groupe sanguin\" required><\/div><div id=\"wpforms-1721-field_46-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_46\">A-t-il des allergies ? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1721-field_46\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_46_1\" name=\"wpforms[fields][46][]\" value=\"Non\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_46_1\">Non<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_46_2\" name=\"wpforms[fields][46][]\" value=\"Alimentaire \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_46_2\">Alimentaire <\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_46_3\" name=\"wpforms[fields][46][]\" value=\"M\u00e9dicamenteuse\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_46_3\">M\u00e9dicamenteuse<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_46_5\" name=\"wpforms[fields][46][]\" value=\"Autres\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_46_5\">Autres<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_46_4\" name=\"wpforms[fields][46][]\" value=\"Asthme\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_46_4\">Asthme<\/label><\/li><\/ul><\/div><div id=\"wpforms-1721-field_28-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"28\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_28\">Allergies ou non<\/label><textarea id=\"wpforms-1721-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\" placeholder=\"Si votre enfant pr\u00e9sente une quelconque allergie, pr\u00e9cisez le.\" ><\/textarea><\/div><div id=\"wpforms-1721-field_45-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_45\">Vaccins (Lesquels de ces vaccins ont \u00e9t\u00e9 administr\u00e9s \u00e0 votre enfant ) <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1721-field_45\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_1\" name=\"wpforms[fields][45][]\" value=\"Vaccin Hexavalent (Poliomy\u00e9lite, Dipht\u00e9rie, T\u00e9tanos, Coqueluche, H\u00e9patite B, Haemophilus influenza type B) \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_1\">Vaccin Hexavalent (Poliomy\u00e9lite, Dipht\u00e9rie, T\u00e9tanos, Coqueluche, H\u00e9patite B, Haemophilus influenza type B) <\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_2\" name=\"wpforms[fields][45][]\" value=\"Papillomavirus\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_2\">Papillomavirus<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_3\" name=\"wpforms[fields][45][]\" value=\"Rougeole\/Rub\u00e9ole\/oreillons\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_3\">Rougeole\/Rub\u00e9ole\/oreillons<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_8\" name=\"wpforms[fields][45][]\" value=\"M\u00e9ningocoque C\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_8\">M\u00e9ningocoque C<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_7\" name=\"wpforms[fields][45][]\" value=\"Rotavirus\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_7\">Rotavirus<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_45_6\" name=\"wpforms[fields][45][]\" value=\"Autres \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_45_6\">Autres <\/label><\/li><\/ul><\/div><div id=\"wpforms-1721-field_33-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"33\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_33\">Autres vaccins<\/label><textarea id=\"wpforms-1721-field_33\" class=\"wpforms-field-medium\" name=\"wpforms[fields][33]\" placeholder=\"Pr\u00e9cisez autres\" ><\/textarea><\/div><div id=\"wpforms-1721-field_47-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"47\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_47\">L\u2019enfant a-t-il d\u00e9j\u00e0 eu les maladies suivantes ? Cochez si oui. <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1721-field_47\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_1\" name=\"wpforms[fields][47][]\" value=\"Rub\u00e9ole \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_1\">Rub\u00e9ole <\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_2\" name=\"wpforms[fields][47][]\" value=\"Varicelle \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_2\">Varicelle <\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_3\" name=\"wpforms[fields][47][]\" value=\"Otite\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_3\">Otite<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_7\" name=\"wpforms[fields][47][]\" value=\"Oreillons \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_7\">Oreillons <\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_6\" name=\"wpforms[fields][47][]\" value=\"Coqueluche \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_6\">Coqueluche <\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_5\" name=\"wpforms[fields][47][]\" value=\"Rougeole \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_5\">Rougeole <\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_4\" name=\"wpforms[fields][47][]\" value=\"Scarlatine\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_4\">Scarlatine<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_9\" name=\"wpforms[fields][47][]\" value=\"Autres\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_9\">Autres<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_47_8\" name=\"wpforms[fields][47][]\" value=\"Ros\u00e9ole \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_47_8\">Ros\u00e9ole <\/label><\/li><\/ul><\/div><div id=\"wpforms-1721-field_35-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"35\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_35\">Autres maladies<\/label><textarea id=\"wpforms-1721-field_35\" class=\"wpforms-field-medium\" name=\"wpforms[fields][35]\" placeholder=\"Pr\u00e9cisez autres\" ><\/textarea><\/div><div id=\"wpforms-1721-field_30-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_30\">Informations et recommandations importantes <\/label><textarea id=\"wpforms-1721-field_30\" class=\"wpforms-field-medium\" name=\"wpforms[fields][30]\" placeholder=\"Merci d\u2019indiquer les \u00e9ventuels probl\u00e8mes ou difficult\u00e9s de sant\u00e9 - \u00e9nur\u00e9sie, maladie, handicap, accident, crises convulsives, op\u00e9rations, r\u00e9\u00e9ducation,... - en indiquant les dates, ainsi que les pr\u00e9cautions \u00e0 prendre. \" ><\/textarea><\/div><div id=\"wpforms-1721-field_48-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_48\">R\u00e9duction<\/label><ul id=\"wpforms-1721-field_48\"><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1721-field_48_2\" name=\"wpforms[fields][48]\" value=\"Je suis le premier enfant de la famille \"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_48_2\">Je suis le premier enfant de la famille <\/label><\/li><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1721-field_48_1\" name=\"wpforms[fields][48]\" value=\"Je suis le 2e \/ 3e \/ 4e enfant de la famille INSCRIT au stage (r\u00e9sidant sous le m\u00eame toit), je profite donc de la r\u00e9duction de 10\u20ac\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_48_1\">Je suis le 2e \/ 3e \/ 4e enfant de la famille INSCRIT au stage (r\u00e9sidant sous le m\u00eame toit), je profite donc de la r\u00e9duction de 10\u20ac<\/label><\/li><\/ul><\/div><div id=\"wpforms-1721-field_37-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_37\">Les photos prises durant les activit\u00e9s de Prendre l\u2019\u00e8re sont consid\u00e9r\u00e9es libres d\u2019utilisation par le centre pour  les outils de communication : sites Internet, publications p\u00e9dagogiques, flyers, \u2026  L\u2019utilisation de ces images n\u2019a d\u2019autre but que d\u2019illustrer les projets et activit\u00e9s organis\u00e9s par Prendre l\u2019\u00e8re.  Cependant, les parents d\u2019enfants mineurs ont l\u2019occasion de s\u2019opposer \u00e0 cette utilisation, merci de compl\u00e9ter  le formulaire suivant pour nous faire part de votre choix. <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_37\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][37][first]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-1721-field_37\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_37-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][37][last]\" placeholder=\"Nom\" required><label for=\"wpforms-1721-field_37-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Nom<\/label><\/div><\/div><div class=\"wpforms-field-description\">Je soussign\u00e9 : <\/div><\/div><div id=\"wpforms-1721-field_38-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"38\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_38\">Lien de parent\u00e9 <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1721-field_38\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][38]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Lien de parent\u00e9<\/option><option value=\"M\u00e8re\" >M\u00e8re<\/option><option value=\"P\u00e8re\" >P\u00e8re<\/option><option value=\"Tuteur\" >Tuteur<\/option><\/select><\/div><div id=\"wpforms-1721-field_44-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"44\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_44\">Autorisation ou non <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1721-field_44\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1721-field_44_1\" name=\"wpforms[fields][44]\" value=\"Autorise \u00e0 l\u2019utilisation, par Prendre l&#039;\u00e8re, de l\u2019image de : \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_44_1\">Autorise \u00e0 l\u2019utilisation, par Prendre l&rsquo;\u00e8re, de l\u2019image de : <\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1721-field_44_2\" name=\"wpforms[fields][44]\" value=\"N&#039;autorise pas l&#039;utilisation, par Prendre l&#039;\u00e8re de l&#039;image de :\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_44_2\">N&rsquo;autorise pas l&rsquo;utilisation, par Prendre l&rsquo;\u00e8re de l&rsquo;image de :<\/label><\/li><\/ul><\/div><div id=\"wpforms-1721-field_40-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"40\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-1721-field_40\">Nom et pr\u00e9nom de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_40\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][40][first]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-1721-field_40\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1721-field_40-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][40][last]\" placeholder=\"Nom\" required><label for=\"wpforms-1721-field_40-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Nom<\/label><\/div><\/div><\/div><div id=\"wpforms-1721-field_54-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-1721-field_54\">Paiement<\/label><ul id=\"wpforms-1721-field_54\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_54_1\" name=\"wpforms[fields][54][]\" value=\"A la r\u00e9servation\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_54_1\">A la r\u00e9servation<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1721-field_54_2\" name=\"wpforms[fields][54][]\" value=\"Au premier jour du stage\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1721-field_54_2\">Au premier jour du stage<\/label><\/li><\/ul><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"1721\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-1721\" class=\"wpforms-submit\" data-alt-text=\"Envoi...\" data-submit-text=\"Envoyer\" aria-live=\"assertive\" value=\"wpforms-submit\">Envoyer<\/button><\/div><\/form><\/div>  <!-- .wpforms-container --><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5fa1f2a elementor-widget elementor-widget-text-editor\" data-id=\"5fa1f2a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\"><strong>Durant les activit\u00e9s de Prendre l&rsquo;\u00e8re :<\/strong><\/span><\/p><ul><li>Je place mon enfant sous l\u2019autorit\u00e9 et la responsabilit\u00e9 de ses animateurs.<\/li><li>Les animateurs m\u2019ont inform\u00e9 des mesures sanitaires li\u00e9es au Covid-19.<\/li><li>En cas de n\u00e9cessit\u00e9 absolue et si vous n\u2019\u00e9tiez pas joignable, c\u2019est au m\u00e9decin de prendre les<br \/>d\u00e9cisions th\u00e9rapeutiques concernant votre enfant.<\/li><\/ul><p><span style=\"text-decoration: underline;\"><strong>Paiement<\/strong> <\/span>:<strong><span style=\"color: #ff0000;\"> Votre r\u00e9servation est effective d\u00e8s la r\u00e9ception du paiement.<\/span><\/strong> Celui-ci est \u00e0 effectuer sur le compte BE69 7320 4536 9678 avec en communication \u00ab stage &#8211; date du stage &#8211; nom de l\u2019enfant &#8211; pr\u00e9nom de l\u2019enfant \u00bb<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>This is Daunfarm Small Farms.Big Ideas. Vestibulum, diam vulputate amet cras in diam quis turpis curabitur tellus aliquet tellus iaculis tempus, sollicitudin massa duis eleifend egestas turpis sit etiam commodo viverra lacinia ipsum convallis sed augue purus scelerisque non vestibulum elementum mi, pellentesque leo tincidunt integer. Learn More Facebook Twitter Youtube Instagram 3300 Del Amo &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/websitedemos.net\/horticulture-02\/\"> <span class=\"screen-reader-text\">Home<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"enabled","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-1731","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/pages\/1731","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/comments?post=1731"}],"version-history":[{"count":23,"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/pages\/1731\/revisions"}],"predecessor-version":[{"id":3010,"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/pages\/1731\/revisions\/3010"}],"wp:attachment":[{"href":"https:\/\/prendrelere.be\/index.php\/wp-json\/wp\/v2\/media?parent=1731"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}