{"id":9379,"date":"2024-08-25T15:44:39","date_gmt":"2024-08-25T13:44:39","guid":{"rendered":"http:\/\/www.plongee-gesma.com\/site\/?p=9379"},"modified":"2024-08-25T16:27:35","modified_gmt":"2024-08-25T14:27:35","slug":"inscriptions-saison-2024-2025","status":"publish","type":"post","link":"https:\/\/www.plongee-gesma.com\/site\/2024\/08\/25\/inscriptions-saison-2024-2025\/","title":{"rendered":"Inscriptions saison 2024\/2025"},"content":{"rendered":"<div data-uniq='6a3b44a664914' class='uniq-6a3b44a664914 formcraft-css form-live align-left'><div style='display: none' class='pre-populate-data'>{&quot;field6&quot;:&quot;&quot;,&quot;field7&quot;:&quot;&quot;,&quot;field94&quot;:&quot;&quot;,&quot;field96&quot;:&quot;&quot;,&quot;field21&quot;:&quot;1&quot;,&quot;field1&quot;:[&quot;&quot;],&quot;field22&quot;:[&quot;&quot;],&quot;field13&quot;:[&quot;&quot;],&quot;field23&quot;:&quot;&quot;,&quot;field25&quot;:[&quot;&quot;],&quot;field26&quot;:[&quot;&quot;],&quot;field28&quot;:[&quot;&quot;],&quot;field8&quot;:&quot;&quot;,&quot;field98&quot;:&quot;&quot;,&quot;field92&quot;:[&quot;&quot;],&quot;field99&quot;:[&quot;&quot;],&quot;field100&quot;:[&quot;&quot;],&quot;field27&quot;:&quot;&quot;,&quot;field86&quot;:&quot;&quot;,&quot;field34&quot;:&quot;&quot;,&quot;field77&quot;:&quot;2&quot;,&quot;field30&quot;:[&quot;&quot;],&quot;field32&quot;:[&quot;&quot;],&quot;field31&quot;:[&quot;&quot;],&quot;field33&quot;:[&quot;&quot;],&quot;field95&quot;:[&quot;&lt;h3&gt;J&#039;autorise le GESMA \u00e0 prendre, le cas \u00e9chant toutes mesures (traitement m\u00e9dical, hospitalisation, intervention chirurgicale) rendues n\u00e9cessaires, soit pour moi-m\u00eame, soit pour mon enfant.&lt;\\\/h3&gt;&quot;],&quot;field29&quot;:&quot;&quot;,&quot;field39&quot;:&quot;&quot;,&quot;field85&quot;:[&quot;&quot;],&quot;field37&quot;:[&quot;&quot;],&quot;field47&quot;:&quot;&quot;,&quot;field48&quot;:&quot;&quot;,&quot;field51&quot;:&quot;&quot;,&quot;field54&quot;:[&quot;1&quot;],&quot;field55&quot;:&quot;&quot;,&quot;field81&quot;:[&quot;0&quot;],&quot;field56&quot;:&quot;&quot;,&quot;field58&quot;:&quot;&quot;,&quot;field78&quot;:&quot;2&quot;,&quot;field59&quot;:[&quot;&quot;],&quot;field79&quot;:[&quot;&quot;],&quot;field80&quot;:&quot;&quot;,&quot;field60&quot;:&quot;&quot;,&quot;field61&quot;:[&quot;Oui&quot;],&quot;field41&quot;:&quot;&quot;,&quot;field43&quot;:&quot;&quot;,&quot;field44&quot;:[&quot;1&quot;],&quot;field82&quot;:&quot;&quot;,&quot;field83&quot;:[&quot;1&quot;],&quot;field65&quot;:&quot;&quot;,&quot;field66&quot;:&quot;&quot;,&quot;field67&quot;:[&quot;1&quot;],&quot;field68&quot;:&quot;&quot;,&quot;field71&quot;:&quot;&quot;,&quot;field97&quot;:&quot;&quot;,&quot;field91&quot;:[&quot;&quot;],&quot;field90&quot;:[&quot;&quot;]}<\/div><script> window.formcraftLogic = window.formcraftLogic || {}; window.formcraftLogic[61] = [[[[\"field81\",\"equal_to\",\"1\"]],[[\"show_fields\",\"field78,field59,field79,field80,field56,field58\"]],\"and\"],[[[\"field69\",\"equal_to\",\"1\"]],[[\"show_fields\",\"field71,field72\"]],\"and\"],[[[\"field21\",\"equal_to\",\"2\"]],[[\"show_fields\",\"field22\"]],\"or\"]]; <\/script><div class=\"fc-pagination-cover fc-pagination-1\">\n\t\t\t\t<div class=\"fc-pagination width-100\">\n\t\t\t\t\t<!-- ngRepeat: page in Builder.FormElements track by $index --><div class=\"pagination-trigger \" data-index=\"0\">\n\t\t\t\t\t\t<span class=\"page-number\"><span >1<\/span><\/span>\n\t\t\t\t\t\t<span class=\"page-name \">Renseignements classiques<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div><!-- end ngRepeat: page in Builder.FormElements track by $index -->\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t<style scoped=\"scoped\" >\n\t\t\t@media (max-width : 480px) {\n\t\t\t\t.fc_modal-dialog-61 .fc-pagination-cover 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.fc-form.fc-form-61 .form-element .field-cover .time-fields-cover,\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover .awesomplete ul\n\t\t\t{\n\t\t\t\tcolor: #000000;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"text\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"password\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"email\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"radio\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"checkbox\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover input[type=\"tel\"],\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover select,\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .field-cover textarea\n\t\t\t{\n\t\t\t\tbackground-color: #cbb3e2;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-61 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input[type=\"tel\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .form-element-html input[type=\"text\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .form-element-html textarea:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .form-element-html select:focus\n\t\t\t{\n\t\t\t\tborder-color: #1e73be;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-61 .form-element .form-element-html .field-cover .is-read-only:focus {\n\t\t\t\tborder-color: #ccc;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-61\t\t\t{\n\t\t\t\tfont-family: inherit;\n\t\t\t}\n\t\t\t@media (max-width : 480px) {\n\t\t\t\thtml .dedicated-page,\n\t\t\t\thtml .dedicated-page .formcraft-css .fc-pagination > div.active\n\t\t\t\t{\n\t\t\t\t\tbackground: #c5e1ea;\n\t\t\t\t}\n\t\t\t}\n\t\t<\/style>\n\t\t<div class=\"form-cover\">\n\t\t\t<form data-auto-scroll=\"\" data-no-message-redirect=\"\" data-thousand=\"\" data-decimal=\".\" data-delay=\"\" data-id=\"61\" class=\"fc-form fc-form-61 align- fc-temp-class remove-asterisk- icons-hide- disable-enter- label-inline field-border-visible frame-visible save-form-false dont-submit-hidden-true field-alignment-left   ng-submitted\" style=\"width: 1200px; color: #000000; font-size: 100%; background: #c5e1ea\">\n\t\t\t\t<!-- ngRepeat: page in Builder.FormElements track by $index --><div class=\"form-page form-page-0\" data-index=\"0\">\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"form-page-content      ng-not-empty\">\n\t\t\t\t\t\t<div data-identifier=\"field6\" data-index=\"0\" style=\"width: 100%\" class=\" form-element form-element-field6 options-false form-element-0 default-false form-element-type-customText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #a9d689\"><div class=\"full\" style=\"text-align: left\"><h3 align=\"center\" >Formulaire n\u00b01 pour s'inscrire dans le club, saison 2025\/2026<\/h3><\/div><input type=\"hidden\" name=\"field6\" data-field-id=\"field6\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field7\" data-index=\"1\" style=\"width: 100%\" class=\" even form-element form-element-field7 options-false form-element-1 default-false form-element-type-customText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #dd9933\"><div class=\"full\" style=\"text-align: left\"><h1 >L' inscription au Gesma n\u00e9cessite la saisie d'au moins de <u>deux formulaires<\/u>.<\/h1><h2 >Le premier formulaire, celui-ci , permet au club de r\u00e9cup\u00e9rer des informations administratives.<\/h2><h1 ><u>A l'issue de celui-ci, vous serez redirig\u00e9 automatiquement vers un deuxi\u00e8me formulaire qui lui concerne essentiellement la formule d'adh\u00e9sion.<\/u><\/h1><h2 >En enfin si vous demandez des formations apn\u00e9e, plongeur bio et\/ou plong\u00e9e, vous serez redirig\u00e9 vers d'autres formulaires.<\/h2><h2 >Veuillez \u00e0 saisir correctement tous les champs des diff\u00e9rents formulaires, \u00e0 bien remplir au moins les deux premiers formulaires.<\/h2><\/div><input type=\"hidden\" name=\"field7\" data-field-id=\"field7\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field94\" data-index=\"2\" style=\"width: 100%\" class=\" form-element form-element-field94 options-false form-element-2 default-false form-element-type-customText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #dd3333 !important; background-color: #dd9933\"><div class=\"full\" style=\"text-align: left\"><h1 >Si l'inscription est pour un mineur alors la partie ci-dessous concerne le responsable l\u00e9gal du mineur.<br>A une certaine \u00e9tape vous pourrez indiquer que l'inscription correspond \u00e0 celle d'un mineur.<\/h1><\/div><input type=\"hidden\" name=\"field94\" data-field-id=\"field94\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field96\" data-index=\"3\" style=\"width: 100%\" class=\" even form-element form-element-field96 form-element-3 default-false form-element-type-customText is-required-false options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #ffffff\"><div class=\"full\" style=\"text-align: left\"><h3 >Les dirigeants du GESMA :<center><table><tbody><tr><td><img decoding=\"async\" src=\"https:\/\/www.plongee-gesma.com\/club_gesma\/Photos\/Photos_membres\/116.png\"><\/td><td><img decoding=\"async\" src=\"http:\/\/www.plongee-gesma.com\/site\/wp-content\/uploads\/2025\/01\/SL.webp\"><\/td><td><img decoding=\"async\" src=\"http:\/\/www.plongee-gesma.com\/site\/wp-content\/uploads\/2025\/01\/FB.webp\"><\/td><\/tr><tr><td>Le pr\u00e9sident<\/td><td>Le tr\u00e9sorier<\/td><td>Le secr\u00e9taire<\/td><\/tr><\/tbody><\/table><\/center>Vous souhaitent une belle saison.<\/h3><\/div><input type=\"hidden\" name=\"field96\" data-field-id=\"field96\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field21\" data-index=\"4\" style=\"width: 100%\" class=\" form-element form-element-field21 options-false form-element-4 default-false form-element-type-dropdown is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"dropdown-cover field-cover autocomplete-type- \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Civilit\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><select data-is-required=\"true\" class=\"validation-lenient\" data-field-id=\"field21\" name=\"field21\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><option value=\"2\" class=\" \">Madame<\/option><option value=\"1\" class=\" \">Monsieur<\/option><option value=\"0\" class=\" \">Mademoiselle<\/option><\/select><input type=\"text\"><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field1\" data-index=\"5\" style=\"width: 100%\" class=\" even form-element form-element-field1 options-false form-element-5 default-false form-element-type-oneLineText is-required-true -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-true\"><span class=\"main-label\"><span >Nom de naissance<\/span><\/span><span class=\"sub-label\"><span >Juste le nom...<\/span><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field1\" name=\"field1[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field22\" data-index=\"6\" style=\"width: 100%\" class=\" form-element form-element-field22 options-false form-element-6 default-true form-element-type-oneLineText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-true\"><span class=\"main-label\"><span >Nom d'usage<\/span><\/span><span class=\"sub-label\"><span >Pour les personnes mari\u00e9es<\/span><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field22\" name=\"field22[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field13\" data-index=\"7\" style=\"width: 100%\" class=\" even form-element form-element-field13 options-false form-element-7 default-false form-element-type-oneLineText is-required-true -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Pr\u00e9nom<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field13\" name=\"field13[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field23\" data-index=\"8\" style=\"width: 100%\" class=\" form-element form-element-field23 options-false form-element-8 default-false form-element-type-datepicker is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"datepicker-cover field-cover \"><span class=\"sub-label-true\"><span class=\"main-label\"><span >N\u00e9(e) le<\/span><\/span><span class=\"sub-label\"><span >Au format : xx\/xx\/xxxxx<\/span><\/span><\/span><div><span class=\"error\"><\/span><input autocomplete=\"off\" data-field-id=\"field23\" placeholder=\"\" type=\"text\" class=\"validation-lenient   hasDatepicker ng-empty  \" data-is-required=\"true\" datepicker=\"\" data-date-min-range=\"\" data-date-format=\"dd\/mm\/yy\" data-date-days=\"{&quot;0&quot;:true,&quot;1&quot;:true,&quot;2&quot;:true,&quot;3&quot;:true,&quot;4&quot;:true,&quot;5&quot;:true,&quot;6&quot;:true}\" data-date-min=\"\" data-date-min-alt=\"\" data-date-max-alt=\"\" data-date-max=\"\" data-date-lang=\"fr\" name=\"field23\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"xx\/xx\/xxxxx\"><i class=\"formcraft-icon\">date_range<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field25\" data-index=\"9\" style=\"width: 100%\" class=\" even form-element form-element-field25 options-false form-element-9 default-false form-element-type-oneLineText is-required-true -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >A<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field25\" name=\"field25[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field26\" data-index=\"10\" style=\"width: 100%\" class=\" form-element form-element-field26 options-false form-element-10 default-false form-element-type-oneLineText is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Code postal de naissance<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field26\" name=\"field26[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"numbers\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field28\" data-index=\"11\" style=\"width: 100%; position: relative; z-index: 999; left: 0px; top: 0px\" class=\" form-element form-element-field28 default-false form-element-type-oneLineText is-required-true even -handle form-element-11 options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover  \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >T\u00e9l\u00e9phone portable<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"00-00-00-00-00\" make-read-only=\"false\" data-field-id=\"field28\" name=\"field28[]\" data-min-char=\"14\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"00-00-00-00-00\" data-mask-placeholder=\"00-00-00-00-00\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field8\" data-index=\"12\" style=\"width: 100%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\" form-element form-element-field8 default-false form-element-type-email is-required-true odd -handle form-element-12 options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"email-cover field-cover \"><span class=\"sub-label-true\"><span class=\"main-label\"><span >Courriel<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input placeholder=\"\" data-field-id=\"field8\" type=\"text\" data-val-type=\"email\" make-read-only=\"\" data-is-required=\"true\" name=\"field8\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\"><i class=\"formcraft-icon\">email<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field98\" data-index=\"13\" style=\"width: 100%; position: relative; z-index: 999; left: 0px; top: -9.75px\" class=\" form-element form-element-field98 default-false form-element-type-customText is-required-false options-false -handle even form-element-13\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color: #ffffff\"><div class=\"full\" style=\"text-align: left\"><p >Adresse personnelle<\/p><\/div><input type=\"hidden\" name=\"field98\" data-field-id=\"field98\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field92\" data-index=\"14\" style=\"width: 100%\" class=\" form-element form-element-field92 default-false form-element-type-oneLineText is-required-true -handle odd form-element-14 options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Adresse<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field92\" name=\"field92[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field99\" data-index=\"15\" style=\"width: 50%\" class=\" form-element form-element-field99 default-false form-element-type-oneLineText is-required-true -handle even form-element-15 options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Code postal<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field99\" name=\"field99[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"rue, code postal et  ville\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field100\" data-index=\"16\" style=\"width: 50%\" class=\" form-element form-element-field100 default-false form-element-type-oneLineText is-required-true -handle odd form-element-16 options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Commune<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field100\" name=\"field100[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"Commune\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field27\" data-index=\"17\" style=\"width: 100%\" class=\" form-element form-element-field27 options-false default-true form-element-type-textarea is-required-false -handle even form-element-17\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"textarea-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Adresse postale o\u00f9 sera exp\u00e9di\u00e9e votre licence (si 1\u00e8re adh\u00e9sion \u00e0 la FFESSM)<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><textarea data-field-id=\"field27\" placeholder=\"\" class=\"validation-lenient\" name=\"field27\" value=\"\" rows=\"5\" data-min-char=\"\" data-max-char=\"\" data-is-required=\"false\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\" style=\"min-height: 110.817px\"><\/textarea><div class=\"count-\"><span class=\"current-count\">0<\/span> \/ <span class=\"max-count \"><\/span><\/div><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field86\" data-index=\"18\" style=\"width: 100%\" class=\" form-element form-element-field86 options-false default-true form-element-type-address is-required-false -handle odd form-element-18\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"address-cover field-cover \"><span class=\"sub-label-\"><span class=\"main-label\"><span >Adresse postale o\u00f9 sera exp\u00e9di\u00e9e votre licence (si 1\u00e8re adh\u00e9sion \u00e0 la FFESSM)<\/span><br ><span >Attention le champ est \u00e0 compl\u00e9ter pour toute mise \u00e0 jour<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input autocomplete=\"off\" class=\"address-picker-field\" type=\"text\" placeholder=\"\" data-show-map=\"false\" data-map-restrict=\"FR\" data-map-height=\"240\" data-field-id=\"field86\"><input class=\"address-picker-field-hidden\" type=\"hidden\" name=\"field86\"><div class=\"address-field-map\"><\/div><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field34\" data-index=\"19\" style=\"width: 100%\" class=\" form-element form-element-field34 options-false default-false form-element-type-customText is-required-false even form-element-19 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Personne<span id=\"selectionBoundary_1719773756875_7595655405772559\" class=\"rangySelectionBoundary\">\ufeff<\/span> \u00e0 pr\u00e9venir en cas d'urgence<\/h2><\/div><input type=\"hidden\" name=\"field34\" data-field-id=\"field34\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field77\" data-index=\"20\" style=\"width: 100%\" class=\" form-element form-element-field77 options-false default-false form-element-type-dropdown is-required-true odd form-element-20 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"dropdown-cover field-cover autocomplete-type- \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Civilit\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><select data-is-required=\"true\" class=\"validation-lenient\" data-field-id=\"field77\" name=\"field77\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><option value=\"2\" class=\" \">Madame<\/option><option value=\"1\" class=\" \">Monsieur<\/option><option value=\"0\" class=\" \">Mademoiselle<\/option><\/select><input type=\"text\"><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field30\" data-index=\"21\" style=\"width: 100%\" class=\" form-element form-element-field30 options-false default-false form-element-type-oneLineText is-required-true even form-element-21 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Nom<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field30\" name=\"field30[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field32\" data-index=\"22\" style=\"width: 100%\" class=\" form-element form-element-field32 options-false default-false form-element-type-oneLineText is-required-true odd form-element-22 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Pr\u00e9nom<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field32\" name=\"field32[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field31\" data-index=\"23\" style=\"width: 100%\" class=\" form-element form-element-field31 options-false default-false form-element-type-oneLineText is-required-true even form-element-23 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lien de parent\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field31\" name=\"field31[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field33\" data-index=\"24\" style=\"width: 100%\" class=\" form-element form-element-field33 options-false default-false form-element-type-oneLineText is-required-true odd form-element-24 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover  \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >N\u00b0 de t\u00e9l\u00e9phone<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"00-00-00-00-00\" make-read-only=\"false\" data-field-id=\"field33\" name=\"field33[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"00-00-00-00-00\" data-mask-placeholder=\"00-00-00-00-00\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field95\" data-index=\"25\" style=\"width: 100%\" class=\" form-element form-element-field95 options-false default-false form-element-type-checkbox is-required-true even form-element-25 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field95\" type=\"checkbox\" data-is-required=\"true\" name=\"field95[]\" value=\"&lt;h3&gt;J'autorise le GESMA \u00e0 prendre, le cas \u00e9chant toutes mesures (traitement m\u00e9dical, hospitalisation, intervention chirurgicale) rendues n\u00e9cessaires, soit pour moi-m\u00eame, soit pour mon enfant.&lt;\/h3&gt;\" class=\"validation-lenient\"><span><h3 >J'autorise le GESMA \u00e0 prendre, le cas \u00e9chant toutes mesures (traitement m\u00e9dical, hospitalisation, intervention chirurgicale) rendues n\u00e9cessaires, soit pour moi-m\u00eame, soit pour mon enfant.<\/h3><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field29\" data-index=\"26\" style=\"width: 100%\" class=\" form-element form-element-field29 default-false form-element-type-customText is-required-false odd form-element-26 -handle options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Dernier dipl\u00f4me de plong\u00e9e obtenu hors Gesma et FFESSM<span id=\"selectionBoundary_1780923517427_8416148618116374\" class=\"rangySelectionBoundary\">\ufeff<\/span> <br><\/h2><\/div><input type=\"hidden\" name=\"field29\" data-field-id=\"field29\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field39\" data-index=\"27\" style=\"width: 50%\" class=\" form-element form-element-field39 options-false default-false form-element-type-datepicker is-required-false even form-element-27 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"datepicker-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Date dernier dipl\u00f4me<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input autocomplete=\"off\" data-field-id=\"field39\" placeholder=\"\" type=\"text\" class=\"validation-lenient   hasDatepicker ng-empty  \" data-is-required=\"false\" datepicker=\"\" data-date-min-range=\"\" data-date-format=\"dd\/mm\/yy\" data-date-days=\"{&quot;0&quot;:true,&quot;1&quot;:true,&quot;2&quot;:true,&quot;3&quot;:true,&quot;4&quot;:true,&quot;5&quot;:true,&quot;6&quot;:true}\" data-date-min=\"\" data-date-min-alt=\"\" data-date-max-alt=\"\" data-date-max=\"\" data-date-lang=\"en\" name=\"field39\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\"><i class=\"formcraft-icon\">date_range<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field85\" data-index=\"28\" style=\"width: 50%\" class=\" form-element form-element-field85 options-false default-false form-element-type-oneLineText is-required-false odd form-element-28 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lieu d'obtention<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field85\" name=\"field85[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field37\" data-index=\"29\" style=\"width: 50%\" class=\" form-element form-element-field37 options-false default-false form-element-type-oneLineText is-required-false even form-element-29 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Diplome de plong\u00e9e<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field37\" name=\"field37[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field40\" data-index=\"30\" style=\"width: 100%\" class=\" form-element form-element-field40 options-false default-false form-element-type-fileupload is-required-false odd form-element-30 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"wide- fileupload-cover field-cover\"><span class=\"sub-label-\"><span class=\"main-label\"><span >Fichier de votre dipl\u00f4me<\/span><\/span><span class=\"sub-label\"><span >t\u00e9l\u00e9verser(pdf,png) 5Mo max<\/span><\/span><\/span><div><span class=\"error\"><\/span><div class=\"button button-file fileupload-button\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><i class=\"icon-upload-cloud formcraft-icon\">cloud_upload<\/i><span >Envoyer<\/span><input type=\"file\" data-name-list=\"field40\" name=\"files\" multiple=\"multiple\" data-allow-extensions=\"pdf,png,jpg,jpeg\" data-min-files=\"\" data-max-files=\"\" data-max-size=\"8000\"><\/div><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field47\" data-index=\"31\" style=\"width: 100%\" class=\" form-element form-element-field47 options-false default-false form-element-type-customText is-required-false even form-element-31 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Attestation mat\u00e9riel et r\u00e8glement<span id=\"selectionBoundary_1686936306090_19598395162978022\" class=\"rangySelectionBoundary\">\ufeff<\/span> int\u00e9rieur<br><\/h2><\/div><input type=\"hidden\" name=\"field47\" data-field-id=\"field47\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field48\" data-index=\"32\" style=\"width: 100%\" class=\" form-element form-element-field48 options-false default-false form-element-type-customText is-required-false odd form-element-32 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Je soussign\u00e9 [FIELD1] [FIELD22] [FIELD13] <br>d\u00e9clare \u00eatre tenu(e) responsable de l'\u00e9tat mat\u00e9riel du mat\u00e9riel que j\u2019aurai emprunt\u00e9 durant les activit\u00e9s pratiqu\u00e9es au sein du club GESMA. <\/h2><\/div><input type=\"hidden\" name=\"field48\" data-field-id=\"field48\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field51\" data-index=\"33\" style=\"width: 100%\" class=\" form-element form-element-field51 options-false default-false form-element-type-customText is-required-false even form-element-33 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Je soussign\u00e9&nbsp; [FIELD1] [FIELD22] [FIELD13]<br>reconnait avoir pris connaissance de la totalit\u00e9 de la fiche d\u2019inscription et notamment les dispositions sur l\u2019assurance individuelle compl\u00e9mentaire et le r\u00e8glement int\u00e9rieur du Club avec ses chartes.<br><\/h2><\/div><input type=\"hidden\" name=\"field51\" data-field-id=\"field51\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field54\" data-index=\"34\" style=\"width: 100%\" class=\" form-element form-element-field54 options-false default-false form-element-type-checkbox is-required-true odd form-element-34 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lu et approuv\u00e9<\/span><br ><span >Mat\u00e9riel&amp;RI<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field54\" type=\"checkbox\" data-is-required=\"true\" name=\"field54[]\" value=\"1\" class=\"validation-lenient\"><span><span >OUI<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field55\" data-index=\"35\" style=\"width: 100%\" class=\" form-element form-element-field55 options-false default-false form-element-type-customText is-required-false even form-element-35 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Autorisation parentale pour les mineurs<\/h2><\/div><input type=\"hidden\" name=\"field55\" data-field-id=\"field55\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field81\" data-index=\"36\" style=\"width: 100%\" class=\" form-element form-element-field81 options-false default-false form-element-type-checkbox is-required-true odd form-element-36 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Inscription pour un mineur ?<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field81\" type=\"radio\" data-is-required=\"true\" name=\"field81[]\" value=\"1\" class=\"validation-lenient\"><span><span >OUI<\/span><\/span><\/label><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field81\" type=\"radio\" data-is-required=\"true\" name=\"field81[]\" value=\"0\" class=\"validation-lenient\"><span><span >NON<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field56\" data-index=\"37\" style=\"width: 100%\" class=\" form-element form-element-field56 options-false default-true form-element-type-customText is-required-false even form-element-37 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Je soussign\u00e9 [FIELD1] [FIELD22] [FIELD13] <br><\/h2><\/div><input type=\"hidden\" name=\"field56\" data-field-id=\"field56\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field58\" data-index=\"38\" style=\"width: 100%\" class=\" form-element form-element-field58 options-false default-true form-element-type-customText is-required-false odd form-element-38 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Autorise mon enfant <br><\/h2><\/div><input type=\"hidden\" name=\"field58\" data-field-id=\"field58\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field78\" data-index=\"39\" style=\"width: 100%\" class=\" form-element form-element-field78 options-false default-true form-element-type-dropdown is-required-true even form-element-39 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"dropdown-cover field-cover autocomplete-type- \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Civilit\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><select data-is-required=\"true\" class=\"validation-lenient\" data-field-id=\"field78\" name=\"field78\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><option value=\"2\" class=\" \">Madame<\/option><option value=\"1\" class=\" \">Monsieur<\/option><option value=\"0\" class=\" \">Mademoiselle<\/option><\/select><input type=\"text\"><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field59\" data-index=\"40\" style=\"width: 100%\" class=\" form-element form-element-field59 options-false default-true form-element-type-oneLineText is-required-true odd form-element-40 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Nom de l'enfant<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field59\" name=\"field59[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field79\" data-index=\"41\" style=\"width: 100%\" class=\" form-element form-element-field79 options-false default-true form-element-type-oneLineText is-required-true even form-element-41 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Pr\u00e9nom de l'enfant<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field79\" name=\"field79[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field80\" data-index=\"42\" style=\"width: 100%\" class=\" form-element form-element-field80 options-false default-true form-element-type-datepicker is-required-true odd form-element-42 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"datepicker-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Date de naissance de l'enfant<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input autocomplete=\"off\" data-field-id=\"field80\" placeholder=\"\" type=\"text\" class=\"validation-lenient   hasDatepicker ng-empty  \" data-is-required=\"true\" datepicker=\"\" data-date-min-range=\"\" data-date-format=\"dd\/mm\/yy\" data-date-days=\"{&quot;0&quot;:true,&quot;1&quot;:true,&quot;2&quot;:true,&quot;3&quot;:true,&quot;4&quot;:true,&quot;5&quot;:true,&quot;6&quot;:true}\" data-date-min=\"\" data-date-min-alt=\"\" data-date-max-alt=\"\" data-date-max=\"\" data-date-lang=\"fr\" name=\"field80\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\"><i class=\"formcraft-icon\">date_range<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field60\" data-index=\"43\" style=\"width: 100%\" class=\" form-element form-element-field60 options-false default-true form-element-type-customText is-required-false even form-element-43 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 ><\/h2><h2 >\u00e0 pratiquer la nage avec palmes et\/ou de l'apn\u00e9e et\/ou de la plong\u00e9e sous-marine en scaphandre, en piscine et\/ou en milieu naturel, dans le cadre des activit\u00e9s du GESMA et en autorise son hospitalisation en cas de n\u00e9cessit\u00e9.<\/h2><h2 >La communication du club se fera sur l'adresse mail du responsable.<\/h2><\/div><input type=\"hidden\" name=\"field60\" data-field-id=\"field60\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field61\" data-index=\"44\" style=\"width: 100%\" class=\" form-element form-element-field61 options-false default-true form-element-type-checkbox is-required-true odd form-element-44 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lu et approuv\u00e9<\/span><br ><span >autorisation parentale (mineur)<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field61\" type=\"checkbox\" data-is-required=\"true\" name=\"field61[]\" value=\"Oui\" class=\"validation-lenient\"><span><span >Oui<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field41\" data-index=\"45\" style=\"width: 100%\" class=\" form-element form-element-field41 options-false default-false form-element-type-customText is-required-false even form-element-45 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Autorisation photos et coordonn\u00e9es<\/h2><\/div><input type=\"hidden\" name=\"field41\" data-field-id=\"field41\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field43\" data-index=\"46\" style=\"width: 100%\" class=\" form-element form-element-field43 options-false default-false form-element-type-customText is-required-false odd form-element-46 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Je soussign\u00e9(e) [FIELD1] [FIELD22] [FIELD13] d\u00e9clare AUTORISER* ou NE PAS AUTORISER* le club \u00e0 diffuser des photos de moi m\u00eame ou de mon enfant sur des supports de communication internet <\/h2><\/div><input type=\"hidden\" name=\"field43\" data-field-id=\"field43\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field44\" data-index=\"47\" style=\"width: 100%\" class=\" form-element form-element-field44 options-false default-false form-element-type-checkbox is-required-true even form-element-47 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >droit image<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field44\" type=\"radio\" data-is-required=\"true\" name=\"field44[]\" value=\"1\" class=\"validation-lenient\"><span><span >Autoriser<\/span><\/span><\/label><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field44\" type=\"radio\" data-is-required=\"true\" name=\"field44[]\" value=\"0\" class=\"validation-lenient\"><span><span >Ne pas autoriser<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field82\" data-index=\"48\" style=\"width: 100%\" class=\" form-element form-element-field82 options-false default-false form-element-type-customText is-required-false odd form-element-48 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 >Je soussign\u00e9(e) [FIELD1] [FIELD22] [FIELD13] d\u00e9clare AUTORISER* ou NE PAS AUTORISER* le club \u00e0 diffuser mes coordonn\u00e9es t\u00e9l mail et adresse postale sur son site.<\/h2><\/div><input type=\"hidden\" name=\"field82\" data-field-id=\"field82\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field83\" data-index=\"49\" style=\"width: 100%\" class=\" form-element form-element-field83 options-false default-false form-element-type-checkbox is-required-true even form-element-49 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >droit diffusion coordonn\u00e9es<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field83\" type=\"radio\" data-is-required=\"true\" name=\"field83[]\" value=\"1\" class=\"validation-lenient\"><span><span >Autoriser<\/span><\/span><\/label><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field83\" type=\"radio\" data-is-required=\"true\" name=\"field83[]\" value=\"0\" class=\"validation-lenient\"><span><span >Ne pas autoriser<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field65\" data-index=\"50\" style=\"width: 100%\" class=\" form-element form-element-field65 options-false default-false form-element-type-customText is-required-false odd form-element-50 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Autorisation recueil d'informations<\/h2><\/div><input type=\"hidden\" name=\"field65\" data-field-id=\"field65\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field66\" data-index=\"51\" style=\"width: 100%\" class=\" form-element form-element-field66 options-false default-false form-element-type-customText is-required-false even form-element-51 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 ><\/h2><h2 >Je soussign\u00e9 [FIELD1] [FIELD22] [FIELD13] \u200b<\/h2><h2 >d\u00e9clare ACCEPTER que les informations recueillies sur ce formulaire soient enregistr\u00e9es dans un fichier informatis\u00e9 par le secr\u00e9taire du Club pour la gestion du club.<\/h2><\/div><input type=\"hidden\" name=\"field66\" data-field-id=\"field66\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field67\" data-index=\"52\" style=\"width: 100%\" class=\" form-element form-element-field67 options-false default-false form-element-type-checkbox is-required-true odd form-element-52 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lu et approuv\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field67\" type=\"checkbox\" data-is-required=\"true\" name=\"field67[]\" value=\"1\" class=\"validation-lenient\"><span><span >OUI<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field68\" data-index=\"53\" style=\"width: 100%\" class=\" form-element form-element-field68 options-false default-false form-element-type-customText is-required-false even form-element-53 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color: #eeee22\"><div class=\"full\" style=\"text-align: left\"><h2 >Honorabilit\u00e9 des encadrants<\/h2><\/div><input type=\"hidden\" name=\"field68\" data-field-id=\"field68\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field69\" data-index=\"54\" style=\"width: 100%\" class=\" form-element form-element-field69 options-false default-false form-element-type-checkbox is-required-true odd form-element-54 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Etes-vous encadrants ?<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field69\" type=\"radio\" data-is-required=\"true\" name=\"field69[]\" value=\"1\" class=\"validation-lenient\"><span><span >OUI<\/span><\/span><\/label><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field69\" type=\"radio\" data-is-required=\"true\" name=\"field69[]\" value=\"0\" class=\"validation-lenient\"><span><span >NON<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field71\" data-index=\"55\" style=\"width: 100%\" class=\" form-element form-element-field71 options-false default-true form-element-type-customText is-required-false even form-element-55 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #000000 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h2 ><ul><li>Le club informe le dirigeant ou encadrant que les \u00e9l\u00e9ments constitutifs de son identit\u00e9 seront transmis par la FFESSM aux services de l\u2019Etat afin qu\u2019un contr\u00f4le automatis\u00e9 de son honorabilit\u00e9 au sens des articles  L. 212.9 et L. 322.1 du code du sport puisse \u00eatre effectu\u00e9.<\/li><li>Le dirigeant  a compris et accepte le contr\u00f4le en signant le pr\u00e9sent bulletin d\u2019adh\u00e9sion qui doit \u00eatre conserv\u00e9 au sein du club.NOTA&nbsp;: si le dirigeant n\u2019accepte pas les conditions ci-dessus, il est dans l\u2019obligation de quitter sa fonction de dirigeant au sein du club et ne peut faire l\u2019objet d\u2019un enregistrement par le club.<\/li><\/ul><\/h2><\/div><input type=\"hidden\" name=\"field71\" data-field-id=\"field71\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field72\" data-index=\"56\" style=\"width: 100%\" class=\" form-element form-element-field72 options-false default-true form-element-type-checkbox is-required-true odd form-element-56 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Lu et approuv\u00e9<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field72\" type=\"checkbox\" data-is-required=\"true\" name=\"field72[]\" value=\"1\" class=\"validation-lenient\"><span><span >Oui<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field97\" data-index=\"57\" style=\"width: 100%\" class=\" form-element form-element-field97 options-false default-false form-element-type-customText is-required-false even form-element-57 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color: #ffffff\"><div class=\"full\" style=\"text-align: left\"><h2 >En validant le bouton ci-dessous, vous recevrez un mail (v\u00e9rifier qu'il ne soit pas dans les SPAM) avec une pi\u00e8ce jointe contenant les informations saisies.<\/h2><\/div><input type=\"hidden\" name=\"field97\" data-field-id=\"field97\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field73\" data-index=\"58\" style=\"width: 100%\" class=\" form-element form-element-field73 options-false default-false form-element-type-submit is-required-false odd form-element-58 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"align-center wide-false submit-cover field-cover\"><button type=\"submit\" class=\"button submit-button\"><span class=\"text \">Valider et passer au formulaire tarifs<\/span><span class=\"spin-cover\"><i style=\"color:\" class=\"loading-icon icon-cog animate-spin\"><\/i><\/span><\/button><\/div><div class=\"submit-response \"><\/div><label ><input type=\"text\" class=\"required_field\" name=\"website\" autocomplete=\"maple-syrup-pot\"><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field91\" data-index=\"59\" style=\"width: 100%\" class=\" form-element form-element-field91 options-false default-false form-element-type-oneLineText is-required-false even form-element-59 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-true\"><span class=\"main-label\"><span >Id_membre<\/span><\/span><span class=\"sub-label\"><span >Ne vous concerne pas...<\/span><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"true\" data-field-id=\"field91\" name=\"field91[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field90\" data-index=\"60\" style=\"width: 100%\" class=\" form-element form-element-field90 options-false default-true form-element-type-oneLineText is-required-false odd form-element-60 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover \"><span class=\"sub-label-false\"><span class=\"main-label\"><span >Mise_a_jour<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"false\" data-field-id=\"field90\" name=\"field90[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-\"><\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div><!-- end ngRepeat: page in Builder.FormElements track by $index -->\n\t\t\t<\/form>\n\t\t\t<div class=\"prev-next prev-next-1\" style=\"width: 1200px; color: #000000; font-size: 100%; background: #c5e1ea\">\n\t\t\t\t<div>\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"inactive page-prev \"><i class=\"formcraft-icon\">keyboard_arrow_left<\/i>Retour<\/span><\/div>\n\t\t\t\t<div>\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"page-next \">Suivant<i class=\"formcraft-icon\">keyboard_arrow_right<\/i><\/span><\/div>\n\t\t\t<\/div>\n\t\t<\/div><a class=\"powered-by\" target=\"_blank\" href=\"http:\/\/formcraft-wp.com?source=pb\"\/>FormCraft - G\u00e9n\u00e9rateur de formulaires WordPress<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"on","ocean_gallery_id":[],"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[64,1],"tags":[],"class_list":["post-9379","post","type-post","status-publish","format-standard","hentry","category-dossier-inscription","category-non-classe","entry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/paxHzL-2rh","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/posts\/9379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/comments?post=9379"}],"version-history":[{"count":17,"href":"https:\/\/www.plongee-gesma.com\/site\/wp-json\/wp\/v2\/posts\/9379\/revisions"}],"predecessor-version":[{"id":9431,"href":"https:\/\/www.plongee-gesma.com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