{"id":885,"date":"2018-06-18T13:34:37","date_gmt":"2018-06-18T11:34:37","guid":{"rendered":"https:\/\/www.clubugc.be\/?page_id=885"},"modified":"2018-06-20T15:47:36","modified_gmt":"2018-06-20T13:47:36","slug":"inscription","status":"publish","type":"page","link":"https:\/\/www.clubugc.be\/index.php\/inscription\/","title":{"rendered":"Rejoignez-nous"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f215-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"215\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/885#wpcf7-f215-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"215\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f215-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"subscription-form-inner\">\n\t<div id=\"accordion\">\n\t\t<div>\n\t\t\t<div id=\"master-info-title\" class=\"title-step\">\n\t\t\t\t<p><span class=\"btn btn-link\" data-toggle=\"collapse\" aria-expanded=\"true\" aria-controls=\"master-info\" data-target=\"#master-info\">1. Vos informations<\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"collapse show\" aria-labelledby=\"master-info-title\" data-parent=\"#accordion\" id=\"master-info\">\n\t\t\t\t<div class=\"form-group form-step\">\n\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"firstname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Pr\u00e9nom\" value=\"\" type=\"text\" name=\"firstname\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lastname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nom*\" value=\"\" type=\"text\" name=\"lastname\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"BirthDate\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Date de naissance*\" value=\"\" type=\"text\" name=\"BirthDate\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Adresse\" value=\"\" type=\"text\" name=\"address\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email*\" value=\"\" type=\"email\" name=\"email\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel form-control\" aria-invalid=\"false\" placeholder=\"T\u00e9l\u00e9phone\" value=\"\" type=\"tel\" name=\"tel\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"source\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Comment avez-vous connu l&#039;UGC?\" value=\"\" type=\"text\" name=\"source\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p style=\"text-align: center;\"><br \/>\nJ'ai une assurance RC vie priv\u00e9e (familiale) qui couvre \u00e9galement mon chien<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-564\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-564\" value=\"Oui\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-564\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span><br \/>\nJe marque mon accord pour payer la prime d\u2019assurance annuelle impos\u00e9e par l\u2019URSCH\/AdD en sus de la cotisation annuelle<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-664\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-664\" value=\"Oui\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-664\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span><br \/>\nJe marque mon accord pour que les photos prises de moi puissent \u00eatre publi\u00e9es en vue de la promotion du club<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-965\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-965\" value=\"Oui\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-965\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ROI\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"ROI\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">J\u2019ai lu et accepte le <a href= \"https:\/\/www.clubugc.be\/wp-content\/uploads\/2019\/08\/ROI_UGC_2019.pdf\" target=\"_blank\">R\u00c8GLEMENT D\u2019ORDRE INT\u00c9RIEUR de l\u2019UGC<\/a><\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div>\n\t\t\t<div id=\"dog-info-title\" class=\"title-step\">\n\t\t\t\t<p><span class=\"btn btn-link\" data-toggle=\"collapse\" aria-expanded=\"true\" aria-controls=\"dog-info\" data-target=\"#dog-info\">2. A propos du chien<\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"collapse show\" aria-labelledby=\"dog-info-title\" data-parent=\"#accordion\" id=\"dog-info\">\n\t\t\t\t<div class=\"dog-info officialname class:form-control placeholder \"Nom officiel du chien*\"]\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-237\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-237\" value=\"M\u00e2le\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">M\u00e2le<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-237\" value=\"Femelle\" \/><span class=\"wpcf7-list-item-label\">Femelle<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"officiallname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nom officiel du chien*\" value=\"\" type=\"text\" name=\"officiallname\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"usualname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Nom usuel du chien\" value=\"\" type=\"text\" name=\"usualname\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"race\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Race*\" value=\"\" type=\"text\" name=\"race\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pedigre-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"N\u00b0 Pr\u00e9digree\" value=\"\" type=\"text\" name=\"pedigre-number\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"birthday\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Date de naissance\" value=\"\" type=\"text\" name=\"birthday\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"microchip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Microchip\" value=\"\" type=\"text\" name=\"microchip\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div>\n\t\t\t<div id=\"payment-info-title\" class=\"title-step\">\n\t\t\t\t<p><span class=\"btn btn-link\" data-toggle=\"collapse\" aria-expanded=\"true\" aria-controls=\"payment-info\" data-target=\"#payment-info\"><br \/>\n3. Informations de paiement<\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"collapse show\" aria-labelledby=\"payment-info-title\" data-parent=\"#accordion\" id=\"payment-info\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p>N\u00b0 de compte: BE59 2710 6101 2426\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p>BIC: GEBABEBB\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p>Iban: BE59271061012426\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p>Montant: 80\u20ac +7\u20ac\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t<p>Votre inscription ne sera valid\u00e9e qu'apr\u00e8s r\u00e9ception du paiement\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"text-center mt-3\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"spam-quiz\"><label><span class=\"wpcf7-quiz-label\">Combien font 2 - 1?<\/span> <input size=\"2\" maxlength=\"2\" class=\"wpcf7-form-control wpcf7-quiz\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" type=\"text\" name=\"spam-quiz\" \/><\/label><input type=\"hidden\" name=\"_wpcf7_quiz_answer_spam-quiz\" value=\"e74327cc21f8bb55a59627dc2c9fe533\" \/><\/span><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n\t\t<\/p>\n\t<\/div>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"168\"\/><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n\/* ]]> *\/\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"1. Vos informations J'ai une assurance RC vie priv\u00e9e (familiale) qui couvre \u00e9galement mon chien OuiNon Je marque mon accord pour payer la prime d\u2019assurance&hellip;","protected":false},"author":6339,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-885","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/pages\/885","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/users\/6339"}],"replies":[{"embeddable":true,"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/comments?post=885"}],"version-history":[{"count":4,"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/pages\/885\/revisions"}],"predecessor-version":[{"id":1037,"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/pages\/885\/revisions\/1037"}],"wp:attachment":[{"href":"https:\/\/www.clubugc.be\/index.php\/wp-json\/wp\/v2\/media?parent=885"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}