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<form class="af-form acf-form" method="POST" action="https://www.cpa-lathus.asso.fr/reservation/?camp=402" id="form_5b0ead89da5a7" enctype="multipart/form-data"><div class="af-fields acf-fields acf-form-fields -top"> <div id="acf-form-data" class="acf-hidden">
<input type="hidden" id="_acf_screen" name="_acf_screen" value="acf_form"><input type="hidden" id="_acf_post_id" name="_acf_post_id" value="0"><input type="hidden" id="_acf_validation" name="_acf_validation" value="1"><input type="hidden" id="_acf_form" name="_acf_form" value="0"><input type="hidden" id="_acf_nonce" name="_acf_nonce" value="5036bbef48"><input type="hidden" id="_acf_changed" name="_acf_changed" value="0"> </div>
<div class="acf-hidden"><input type="hidden" name="_acfnonce" value="1c7efe51f8"><input type="hidden" name="nonce" value="1c7efe51f8"><input type="hidden" name="af_form" value="form_5b0ead89da5a7"><input type="hidden" name="af_form_args" value="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"><input type="hidden" name="_acf_form" value="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"></div><div id="" class="af-field af-field-type-button-group af-field-typeReservation acf-field acf-field-button-group acf-field-5b1fe85289eb0" data-name="typeReservation" data-key="field_5b1fe85289eb0" data-type="button_group"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b1fe85289eb0" class="text-md-right">Type de réservation</label></div><div class="col-md-7 af-input acf-input"><input type="hidden" name="acf[field_5b1fe85289eb0]"><div class=" btn-group btn-group-toggle"><label class="btn btn-outline selected"><input type="radio" name="acf[field_5b1fe85289eb0]" value="Particulier" checked="checked"> Particulier</label><label class="btn btn-outline"><input type="radio" name="acf[field_5b1fe85289eb0]" value="Structure"> Famille ou structure d’accueil</label></div></div></div></div><div id="" class="af-field af-field-type-number af-field-id acf-field acf-field-number acf-field-5b153529ba3dd d-none" data-name="id" data-key="field_5b153529ba3dd" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3dd" class="text-md-right">Id de la réservation</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="number" id="acf-field_5b153529ba3dd" class="form-control" name="acf[field_5b153529ba3dd]" step="any"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-numeroCamp acf-field acf-field-text acf-field-5b153529ba3e3 af-field-required d-none" data-name="numeroCamp" data-key="field_5b153529ba3e3" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3e3" class="text-md-right">Numéro de la session du camp <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3e3" class="form-control" name="acf[field_5b153529ba3e3]" value="402" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-nomCamp acf-field acf-field-text acf-field-5b153529ba3e6 af-field-required d-none" data-name="nomCamp" data-key="field_5b153529ba3e6" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3e6" class="text-md-right">Nom du camp <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3e6" class="form-control" name="acf[field_5b153529ba3e6]" value="Fermiers en herbe" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-dateDebutSejourCamp acf-field acf-field-text acf-field-5b153529ba3e9 af-field-required d-none" data-name="dateDebutSejourCamp" data-key="field_5b153529ba3e9" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3e9" class="text-md-right">Date de début du séjour <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3e9" class="form-control" name="acf[field_5b153529ba3e9]" value="27/07/2025" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-dateFinSejourCamp acf-field acf-field-text acf-field-5b153529ba3eb af-field-required d-none" data-name="dateFinSejourCamp" data-key="field_5b153529ba3eb" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3eb" class="text-md-right">Date de fin de séjour <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3eb" class="form-control" name="acf[field_5b153529ba3eb]" value="01/08/2025" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-codeTarifSejourCamp acf-field acf-field-text acf-field-5b153529ba3ee af-field-required d-none" data-name="codeTarifSejourCamp" data-key="field_5b153529ba3ee" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3ee" class="text-md-right">Code tarif séjour <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3ee" class="form-control" name="acf[field_5b153529ba3ee]" value="A3" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-id acf-field acf-field-text acf-field-5b153529ba3f2 d-none" data-name="enfant_id" data-key="field_5b153529ba3f2" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3f2" class="text-md-right">enfant_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3f2" class="form-control" name="acf[field_5b153529ba3f2]"></div></div></div></div><div id="" class="uppercaseField af-field af-field-type-text af-field-enfant-nom acf-field acf-field-text acf-field-5b153529ba3f6 af-field-required" data-name="enfant_nom" data-key="field_5b153529ba3f6" data-type="text"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Enfant</h2></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3f6" class="text-md-right">Nom <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3f6" class="form-control" name="acf[field_5b153529ba3f6]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-prenom acf-field acf-field-text acf-field-5b153529ba3f9 af-field-required" data-name="enfant_prenom" data-key="field_5b153529ba3f9" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3f9" class="text-md-right">Prénom <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba3f9" class="form-control" name="acf[field_5b153529ba3f9]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-numeroSecuriteSociale acf-field acf-field-text acf-field-5b153529ba43b" data-name="aides_numeroSecuriteSociale" data-key="field_5b153529ba43b" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba43b" class="text-md-right">Numéro de sécurité sociale</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba43b" class="form-control" name="acf[field_5b153529ba43b]"></div></div></div></div><div id="" class="af-field af-field-type-date-picker af-field-enfant-dateDeNaissance acf-field acf-field-date-picker acf-field-5b153529ba3fb af-field-required" data-name="enfant_dateDeNaissance" data-key="field_5b153529ba3fb" data-type="date_picker"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3fb" class="text-md-right">Date de naissance <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="acf-date-picker input-group" data-date_format="dd/mm/yy" data-first_day="1">
<input type="hidden" id="acf-field_5b153529ba3fb" name="acf[field_5b153529ba3fb]" value=""> <input type="text" class="form-control input hasDatepicker" value="" id="dp1744789552921"> </div></div></div></div><div id="" class="af-field af-field-type-button-group af-field-enfant-sexe acf-field acf-field-button-group acf-field-5b153529ba3fe af-field-required" data-name="enfant_sexe" data-key="field_5b153529ba3fe" data-type="button_group"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba3fe" class="text-md-right">Sexe <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><input type="hidden" name="acf[field_5b153529ba3fe]"><div class=" btn-group btn-group-toggle"><label class="btn btn-outline selected"><input type="radio" name="acf[field_5b153529ba3fe]" value="Fille" checked="checked"> Fille</label><label class="btn btn-outline"><input type="radio" name="acf[field_5b153529ba3fe]" value="Garçon"> Garçon</label></div></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-nomResponsable acf-field acf-field-text acf-field-5b212bfd61e66 af-field-required" data-name="enfant_nomResponsable" data-key="field_5b212bfd61e66" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b212bfd61e66" class="text-md-right">Nom et prénom du responsable <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b212bfd61e66" class="form-control" name="acf[field_5b212bfd61e66]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-textarea af-field-enfant-adresse acf-field acf-field-textarea acf-field-5b153529ba401 d-none" data-name="enfant_adresse" data-key="field_5b153529ba401" data-type="textarea"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba401" class="text-md-right">Adresse du responsable</label></div><div class="col-md-7 af-input acf-input"><textarea id="acf-field_5b153529ba401" class="form-control" name="acf[field_5b153529ba401]" rows="3"></textarea></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-adresse1 acf-field acf-field-text acf-field-5b2120d84e57d af-field-required" data-name="enfant_adresse1" data-key="field_5b2120d84e57d" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2120d84e57d" class="text-md-right">Adresse <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b2120d84e57d" class="form-control" name="acf[field_5b2120d84e57d]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-adresse2 acf-field acf-field-text acf-field-5b2120f04e57e" data-name="enfant_adresse2" data-key="field_5b2120f04e57e" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2120f04e57e" class="text-md-right">Complément d'adresse</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b2120f04e57e" class="form-control" name="acf[field_5b2120f04e57e]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-enfant-codePostal acf-field acf-field-number acf-field-5b168cdc8778c af-field-required" data-name="enfant_codePostal" data-key="field_5b168cdc8778c" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b168cdc8778c" class="text-md-right">Code postal <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="number" id="acf-field_5b168cdc8778c" data-cp="enfant_codePostal" class="codePostalField autoComplete form-control" name="acf[field_5b168cdc8778c]" step="any" required="required"></div></div></div></div><div id="" class="uppercaseField af-field af-field-type-select af-field-enfant-ville acf-field acf-field-select acf-field-5b2120bb4e57c af-field-required" data-name="enfant_ville" data-key="field_5b2120bb4e57c" data-type="select"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2120bb4e57c" class="text-md-right">Ville <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><select id="acf-field_5b2120bb4e57c" data-cp="enfant_codePostal" class="villeField autoComplete form-control" name="acf[field_5b2120bb4e57c]" data-ui="0" data-ajax="0" data-multiple="0" data-placeholder="Choisir" data-allow_null="0"></select></div></div></div><div id="" class="af-field af-field-type-email af-field-enfant-mail acf-field acf-field-email acf-field-5b153529ba404 af-field-required" data-name="enfant_mail" data-key="field_5b153529ba404" data-type="email"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba404" class="text-md-right">E-mail du responsable <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="email" id="acf-field_5b153529ba404" class="form-control" name="acf[field_5b153529ba404]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-enfant-telephone acf-field acf-field-text acf-field-5b2275040569d af-field-required" data-name="enfant_telephone" data-key="field_5b2275040569d" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2275040569d" class="text-md-right">Téléphone <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b2275040569d" class="form-control" name="acf[field_5b2275040569d]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-enfant-estFoyer acf-field acf-field-true-false acf-field-5b2275430569f d-none acf-hidden" data-name="enfant_estFoyer" data-key="field_5b2275430569f" data-type="true_false" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b2275430569f" class="text-md-center">Est en foyer</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b2275430569f]" value="0" disabled=""> <label>
<input type="checkbox" id="acf-field_5b2275430569f" name="acf[field_5b2275430569f]" value="1" class="form-control" autocomplete="off" checked="checked" disabled="">
</label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-institution-nom acf-field acf-field-text acf-field-5b212ceb61e6b af-field-required acf-hidden" data-name="institution_nom" data-key="field_5b212ceb61e6b" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Institution</h2></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b212ceb61e6b" class="text-md-right">Nom <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b212ceb61e6b" class="form-control" name="acf[field_5b212ceb61e6b]" required="required" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-textarea af-field-institution-adresse acf-field acf-field-textarea acf-field-5b2121b14e581 d-none acf-hidden" data-name="institution_adresse" data-key="field_5b2121b14e581" data-type="textarea" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2121b14e581" class="text-md-right">Adresse de l'institution</label></div><div class="col-md-7 af-input acf-input"><textarea id="acf-field_5b2121b14e581" class="form-control" name="acf[field_5b2121b14e581]" rows="3" disabled=""></textarea></div></div></div><div id="" class="af-field af-field-type-text af-field-institution-adresse1 acf-field acf-field-text acf-field-5b2122b04e582 af-field-required acf-hidden" data-name="institution_adresse1" data-key="field_5b2122b04e582" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2122b04e582" class="text-md-right">Adresse (institution) <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b2122b04e582" class="form-control" name="acf[field_5b2122b04e582]" required="required" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-institution-adresse2 acf-field acf-field-text acf-field-5b2122b34e583 acf-hidden" data-name="institution_adresse2" data-key="field_5b2122b34e583" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2122b34e583" class="text-md-right">Complément d'adresse</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b2122b34e583" class="form-control" name="acf[field_5b2122b34e583]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-number af-field-institution-codePostal acf-field acf-field-number acf-field-5b2122b84e584 af-field-required acf-hidden" data-name="institution_codePostal" data-key="field_5b2122b84e584" data-type="number" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2122b84e584" class="text-md-right">Code postal <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="number" id="acf-field_5b2122b84e584" data-cp="institution_codePostal" class="codePostalField autoComplete form-control" name="acf[field_5b2122b84e584]" step="any" required="required" disabled=""></div></div></div></div><div id="" class="uppercaseField af-field af-field-type-select af-field-institution-ville acf-field acf-field-select acf-field-5b2121864e580 af-field-required acf-hidden" data-name="institution_ville" data-key="field_5b2121864e580" data-type="select" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2121864e580" class="text-md-right">Ville <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><select id="acf-field_5b2121864e580" data-cp="institution_codePostal" class="villeField autoComplete form-control" name="acf[field_5b2121864e580]" data-ui="0" data-ajax="0" data-multiple="0" data-placeholder="Choisir" data-allow_null="0" disabled=""></select></div></div></div><div id="" class="af-field af-field-type-text af-field-institution-telephone acf-field acf-field-text acf-field-5b22743f0569b af-field-required acf-hidden" data-name="institution_telephone" data-key="field_5b22743f0569b" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b22743f0569b" class="text-md-right">Téléphone <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b22743f0569b" class="form-control" name="acf[field_5b22743f0569b]" required="required" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-email af-field-institution-mail acf-field acf-field-email acf-field-5b2121224e57f af-field-required acf-hidden" data-name="institution_mail" data-key="field_5b2121224e57f" data-type="email" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2121224e57f" class="text-md-right">E-mail <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="email" id="acf-field_5b2121224e57f" class="form-control" name="acf[field_5b2121224e57f]" required="required" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-pere-id acf-field acf-field-text acf-field-5b153529ba408 d-none" data-name="pere_id" data-key="field_5b153529ba408" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba408" class="text-md-right">pere_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba408" class="form-control" name="acf[field_5b153529ba408]"></div></div></div></div><div id="" class="uppercaseField af-field af-field-type-text af-field-pere-nom acf-field acf-field-text acf-field-5b153529ba40a af-field-required" data-name="pere_nom" data-key="field_5b153529ba40a" data-type="text"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Parent #1</h2></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba40a" class="text-md-right">Nom <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba40a" class="form-control" name="acf[field_5b153529ba40a]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-pere-prenom acf-field acf-field-text acf-field-5b153529ba40d af-field-required" data-name="pere_prenom" data-key="field_5b153529ba40d" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba40d" class="text-md-right">Prénom <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba40d" class="form-control" name="acf[field_5b153529ba40d]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-pere-telephonePortable acf-field acf-field-text acf-field-5b153529ba413 af-field-required" data-name="pere_telephonePortable" data-key="field_5b153529ba413" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba413" class="text-md-right">Téléphone portable <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba413" class="form-control" name="acf[field_5b153529ba413]" required="required"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-pere-telephoneDomicile acf-field acf-field-text acf-field-5b153529ba410" data-name="pere_telephoneDomicile" data-key="field_5b153529ba410" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba410" class="text-md-right">Téléphone du domicile</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba410" class="form-control" name="acf[field_5b153529ba410]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-pere-telephoneTravail acf-field acf-field-text acf-field-5b153529ba415" data-name="pere_telephoneTravail" data-key="field_5b153529ba415" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba415" class="text-md-right">Téléphone du travail</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba415" class="form-control" name="acf[field_5b153529ba415]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-mere-id acf-field acf-field-text acf-field-5b153529ba419 d-none" data-name="mere_id" data-key="field_5b153529ba419" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba419" class="text-md-right">mere_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba419" class="form-control" name="acf[field_5b153529ba419]"></div></div></div></div><div id="" class="uppercaseField af-field af-field-type-text af-field-mere-nom acf-field acf-field-text acf-field-5b153529ba41c" data-name="mere_nom" data-key="field_5b153529ba41c" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Particulier"}]]"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Parent #2</h2></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba41c" class="text-md-right">Nom</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba41c" class="form-control" name="acf[field_5b153529ba41c]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-mere-prenom acf-field acf-field-text acf-field-5b153529ba41e" data-name="mere_prenom" data-key="field_5b153529ba41e" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Particulier"}]]"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba41e" class="text-md-right">Prénom</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba41e" class="form-control" name="acf[field_5b153529ba41e]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-mere-telephonePortable acf-field acf-field-text acf-field-5b153529ba424" data-name="mere_telephonePortable" data-key="field_5b153529ba424" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Particulier"}]]"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba424" class="text-md-right">Téléphone portable</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba424" class="form-control" name="acf[field_5b153529ba424]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-mere-telephoneDomicile acf-field acf-field-text acf-field-5b153529ba421" data-name="mere_telephoneDomicile" data-key="field_5b153529ba421" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Particulier"}]]"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba421" class="text-md-right">Téléphone du domicile</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba421" class="form-control" name="acf[field_5b153529ba421]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-mere-telephoneTravail acf-field acf-field-text acf-field-5b153529ba426" data-name="mere_telephoneTravail" data-key="field_5b153529ba426" data-type="text" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Particulier"}]]"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba426" class="text-md-right">Téléphone du travail</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba426" class="form-control" name="acf[field_5b153529ba426]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-id acf-field acf-field-text acf-field-5b153529ba42a d-none" data-name="aides_id" data-key="field_5b153529ba42a" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba42a" class="text-md-right">aides_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba42a" class="form-control" name="acf[field_5b153529ba42a]"></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-aides-allocataireCaf acf-field acf-field-true-false acf-field-5b153529ba42d d-none" data-name="aides_allocataireCaf" data-key="field_5b153529ba42d" data-type="true_false"><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b153529ba42d" class="text-md-center">Allocataire CAF</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b153529ba42d]" value="0"> <label>
<input type="checkbox" id="acf-field_5b153529ba42d" name="acf[field_5b153529ba42d]" value="1" class="form-control" autocomplete="off">
</label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-aides-numeroAllocataireCaf acf-field acf-field-text acf-field-5b153529ba430 d-none acf-hidden" data-name="aides_numeroAllocataireCaf" data-key="field_5b153529ba430" data-type="text" data-conditions="[[{"field":"field_5b153529ba42d","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba430" class="text-md-right">Numéro d'allocataire CAF</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba430" class="form-control" name="acf[field_5b153529ba430]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-aides-allocataireMsa acf-field acf-field-true-false acf-field-5b153529ba433 d-none" data-name="aides_allocataireMsa" data-key="field_5b153529ba433" data-type="true_false"><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b153529ba433" class="text-md-center">Allocataire MSA</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b153529ba433]" value="0"> <label>
<input type="checkbox" id="acf-field_5b153529ba433" name="acf[field_5b153529ba433]" value="1" class="form-control" autocomplete="off">
</label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-aides-numeroAllocataireMsa acf-field acf-field-text acf-field-5b153529ba436 d-none acf-hidden" data-name="aides_numeroAllocataireMsa" data-key="field_5b153529ba436" data-type="text" data-conditions="[[{"field":"field_5b153529ba433","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba436" class="text-md-right">Numéro d'allocataire MSA</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba436" class="form-control" name="acf[field_5b153529ba436]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-autresAides acf-field acf-field-text acf-field-5b153529ba438 d-none" data-name="aides_autresAides" data-key="field_5b153529ba438" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba438" class="text-md-right">Autres aides</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba438" class="form-control" name="acf[field_5b153529ba438]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-nomComiteEntreprise acf-field acf-field-text acf-field-5b153529ba441 d-none" data-name="aides_nomComiteEntreprise" data-key="field_5b153529ba441" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba441" class="text-md-right">Nom du comité d'entreprise partenaire</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba441" class="form-control" name="acf[field_5b153529ba441]"></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-aides-hasClubCpa acf-field acf-field-true-false acf-field-5b20c6a790399" data-name="aides_hasClubCpa" data-key="field_5b20c6a790399" data-type="true_false"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Adhérent Club CPA Lathus</h2></div></div></div><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b20c6a790399" class="text-md-center">Adhérent "Clubs du CPA Lathus"</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b20c6a790399]" value="0"> <label>
<input type="checkbox" id="acf-field_5b20c6a790399" name="acf[field_5b20c6a790399]" value="1" class="form-control acf-switch-input" autocomplete="off">
<div class="acf-switch"><span class="acf-switch-on" style="min-width: 23.8333px;">Oui</span><span class="acf-switch-off" style="min-width: 23.8333px;">Non</span><div class="acf-switch-slider"></div></div> </label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-aides-clubCpa acf-field acf-field-text acf-field-5b153529ba444 acf-hidden" data-name="aides_clubCpa" data-key="field_5b153529ba444" data-type="text" data-conditions="[[{"field":"field_5b20c6a790399","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba444" class="text-md-right">Adhérent "Clubs du CPA Lathus" (préciser)</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba444" class="form-control" name="acf[field_5b153529ba444]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-galop acf-field acf-field-true-false acf-field-5b153529ba47c d-none" data-name="galop" data-key="field_5b153529ba47c" data-type="true_false"><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b153529ba47c" class="text-md-center">Galop</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b153529ba47c]" value="0"> <label>
<input type="checkbox" id="acf-field_5b153529ba47c" name="acf[field_5b153529ba47c]" value="1" class="form-control" autocomplete="off">
</label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-id acf-field acf-field-text acf-field-5b153529ba449 d-none acf-hidden" data-name="equitation_id" data-key="field_5b153529ba449" data-type="text" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba449" class="text-md-right">equitation_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba449" class="form-control" name="acf[field_5b153529ba449]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-anneeLicence acf-field acf-field-text acf-field-5b153529ba44b acf-hidden" data-name="equitation_anneeLicence" data-key="field_5b153529ba44b" data-type="text" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Renseignements complémentaires</h2>
L'enfant est-il ou a-t-il déjà été licencié ?
Merci de renseigner l'année et le numéro de la dernière licence.</div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba44b" class="text-md-right">Année de licence</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba44b" class="form-control" name="acf[field_5b153529ba44b]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-numeroLicence acf-field acf-field-text acf-field-5b153529ba44e acf-hidden" data-name="equitation_numeroLicence" data-key="field_5b153529ba44e" data-type="text" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba44e" class="text-md-right">Numéro de licence</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba44e" class="form-control" name="acf[field_5b153529ba44e]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-equitation-nouvelleLicence acf-field acf-field-true-false acf-field-5b153529ba451 acf-hidden" data-name="equitation_nouvelleLicence" data-key="field_5b153529ba451" data-type="true_false" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b153529ba451" class="text-md-center">Oui, je souhaite prendre une nouvelle licence et je joindrai un chèque de 25 € lors de mon règlement.</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b153529ba451]" value="0" disabled=""> <label>
<input type="checkbox" id="acf-field_5b153529ba451" name="acf[field_5b153529ba451]" value="1" class="form-control acf-switch-input" autocomplete="off" disabled="">
<div class="acf-switch"><span class="acf-switch-on">Oui</span><span class="acf-switch-off">Non</span><div class="acf-switch-slider"></div></div> </label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-adresseNouvelleLicence acf-field acf-field-text acf-field-5b153529ba454 d-none acf-hidden" data-name="equitation_adresseNouvelleLicence" data-key="field_5b153529ba454" data-type="text" data-conditions="[[{"field":"field_5b153529ba451","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba454" class="text-md-right">Adresse</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba454" class="form-control" name="acf[field_5b153529ba454]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-telephoneNouvelleLicence acf-field acf-field-text acf-field-5b153529ba456 d-none acf-hidden" data-name="equitation_telephoneNouvelleLicence" data-key="field_5b153529ba456" data-type="text" data-conditions="[[{"field":"field_5b153529ba451","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba456" class="text-md-right">Téléphone</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba456" class="form-control" name="acf[field_5b153529ba456]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-equitation-adherentClubLathusMontmorillon acf-field acf-field-true-false acf-field-5b153529ba459 acf-hidden" data-name="equitation_adherentClubLathusMontmorillon" data-key="field_5b153529ba459" data-type="true_false" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b153529ba459" class="text-md-center">Oui, l'enfant est adhérent du Club Lathus-Montmorillon</label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b153529ba459]" value="0" disabled=""> <label>
<input type="checkbox" id="acf-field_5b153529ba459" name="acf[field_5b153529ba459]" value="1" class="form-control acf-switch-input" autocomplete="off" disabled="">
<div class="acf-switch"><span class="acf-switch-on">Oui</span><span class="acf-switch-off">Non</span><div class="acf-switch-slider"></div></div> </label>
</div>
</div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-dernierGalopValide acf-field acf-field-text acf-field-5b153529ba45c acf-hidden" data-name="equitation_dernierGalopValide" data-key="field_5b153529ba45c" data-type="text" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba45c" class="text-md-right">Dernier galop validé</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba45c" class="form-control" name="acf[field_5b153529ba45c]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-equitation-galopSouhaite acf-field acf-field-text acf-field-5b153529ba45f acf-hidden" data-name="equitation_galopSouhaite" data-key="field_5b153529ba45f" data-type="text" data-conditions="[[{"field":"field_5b153529ba47c","operator":"==","value":"1"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba45f" class="text-md-right">Galop souhaité</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba45f" class="form-control" name="acf[field_5b153529ba45f]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-text af-field-sejour-id acf-field acf-field-text acf-field-5b153529ba484 d-none" data-name="sejour_id" data-key="field_5b153529ba484" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba484" class="text-md-right">sejour_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba484" class="form-control" name="acf[field_5b153529ba484]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-sejour-montantTotal acf-field acf-field-number acf-field-5b153529ba487" data-name="sejour_montantTotal" data-key="field_5b153529ba487" data-type="number"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Montant du séjour</h2></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba487" class="text-md-right">Total avant options et déductions</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input readonly="readonly" type="number" id="acf-field_5b153529ba487" class="form-control acf-is-appended" name="acf[field_5b153529ba487]" value="463" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-checkbox af-field-sejour-montantOptionPourCalcul acf-field acf-field-checkbox acf-field-5b1fe7b6f14d2" data-name="sejour_montantOptionPourCalcul" data-key="field_5b1fe7b6f14d2" data-type="checkbox"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><p style="text-align: left;">Les camps se déroulent du dimanche (accueil de 15h00 à 17h30) au vendredi (accueil de 17h00
à 19h00). Le CPA Lathus s’adapte à votre emploi du temps et vous propose :</p>
<ul>
<li style="text-align: left;">Option 1 : de décaler la fin du séjour au samedi matin entre 10h00 et 11h00, je rajoute 37 €</li>
<li style="text-align: left;">Option 2 : de lier 2 séjours consécutifs par un week-end au CPA Lathus, je rajoute 90 €.</li>
</ul>
<style>.tb_button {padding:1px;cursor:pointer;border-right: 1px solid #8b8b8b;border-left: 1px solid #FFF;border-bottom: 1px solid #fff;}.tb_button.hover {borer:2px outset #def; background-color: #f8f8f8 !important;}.ws_toolbar {z-index:100000} .ws_toolbar .ws_tb_btn {cursor:pointer;border:1px solid #555;padding:3px} .tb_highlight{background-color:yellow} .tb_hide {visibility:hidden} .ws_toolbar img {padding:2px;margin:0px}</style></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b1fe7b6f14d2" class="text-md-right">Options à cocher</label></div><div class="col-md-7 af-input acf-input"><input type="hidden" name="acf[field_5b1fe7b6f14d2]"><div class="acf-checkbox-list acf-bl ">
<div class="custom-control custom-checkbox"><input type="checkbox" class="custom-control-input" id="acf-field_5b1fe7b6f14d2-Option-1-(je-rajoute-37€)" name="acf[field_5b1fe7b6f14d2][]" value="Option 1 (je rajoute 37€)"><label class="custom-control-label" for="acf-field_5b1fe7b6f14d2-Option-1-(je-rajoute-37€)"> Option 1 (je rajoute 37€)</label></div>
<div class="custom-control custom-checkbox"><input type="checkbox" class="custom-control-input" id="acf-field_5b1fe7b6f14d2-Option-2-(je-rajoute-90€)" name="acf[field_5b1fe7b6f14d2][]" value="Option 2 (je rajoute 90€)"><label class="custom-control-label" for="acf-field_5b1fe7b6f14d2-Option-2-(je-rajoute-90€)"> Option 2 (je rajoute 90€)</label></div>
</div>
</div></div></div><div id="" class="af-field af-field-type-checkbox af-field-sejour-montantOptionStructurePourCalcul acf-field acf-field-checkbox acf-field-5b1fe8a789eb1 d-none acf-hidden" data-name="sejour_montantOptionStructurePourCalcul" data-key="field_5b1fe8a789eb1" data-type="checkbox" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b1fe8a789eb1" class="text-md-right">Je suis une structure d’accueil, je rajoute 15 € pour le « Service Accueil Plus »</label></div><div class="col-md-7 af-input acf-input"><input type="hidden" name="acf[field_5b1fe8a789eb1]" disabled=""><div class="acf-checkbox-list acf-bl ">
<div class="custom-control custom-checkbox"><input type="checkbox" class="custom-control-input" id="acf-field_5b1fe8a789eb1-Je-suis-une-structure-d’accueil,-pour-le-«-Service-Accueil-Plus-»-(+15€)" name="acf[field_5b1fe8a789eb1][]" value="Je suis une structure d’accueil, pour le « Service Accueil Plus » (+15€)" disabled=""><label class="custom-control-label" for="acf-field_5b1fe8a789eb1-Je-suis-une-structure-d’accueil,-pour-le-«-Service-Accueil-Plus-»-(+15€)"> Je suis une structure d’accueil, pour le « Service Accueil Plus » (+15€)</label></div>
</div>
</div></div></div><div id="" class="af-field af-field-type-number af-field-sejour-montantOption acf-field acf-field-number acf-field-5b153529ba489" data-name="sejour_montantOption" data-key="field_5b153529ba489" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba489" class="text-md-right">Options</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">+</span></div><input readonly="readonly" type="number" id="acf-field_5b153529ba489" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b153529ba489]" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-number af-field-sejour-montantOptionStructure acf-field acf-field-number acf-field-5b211d938f114 d-none acf-hidden" data-name="sejour_montantOptionStructure" data-key="field_5b211d938f114" data-type="number" data-conditions="[[{"field":"field_5b1fe85289eb0","operator":"==","value":"Structure"}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b211d938f114" class="text-md-right">Options Structure</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">+</span></div><input readonly="readonly" type="number" id="acf-field_5b211d938f114" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b211d938f114]" min="0" max="1000" step="any" disabled=""><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-reductions-id acf-field acf-field-text acf-field-5b153529ba463 d-none" data-name="reductions_id" data-key="field_5b153529ba463" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba463" class="text-md-right">reductions_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba463" class="form-control" name="acf[field_5b153529ba463]"></div></div></div></div><div id="" class="af-field af-field-type-select af-field-reductions-montantAideCommunePourCalcul acf-field acf-field-select acf-field-5b20d3803cbba" data-name="reductions_montantAideCommunePourCalcul" data-key="field_5b20d3803cbba" data-type="select"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h2>Déduction</h2>
( Vous devez fournir un document justifiant que vous bénéficiez des aides déduites du montant de votre séjour. Sans cela, ces aides ne sont pas valables et le montant vous sera facturé.)</div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b20d3803cbba" class="text-md-right">Aide de la commune</label></div><div class="col-md-7 af-input acf-input"><select id="acf-field_5b20d3803cbba" class="form-control" name="acf[field_5b20d3803cbba]" data-ui="0" data-ajax="0" data-multiple="0" data-placeholder="Choisir" data-allow_null="1"><option value="" selected="selected" data-i="0">- Choisir -</option><option value="Adriers (-80€)">Adriers (-80€)</option><option value="Antigny (-50€)">Antigny (-50€)</option><option value="Asnières-sur-Blour (-50€)">Asnières-sur-Blour (-50€)</option><option value="Availles-Limouzine (-50€)">Availles-Limouzine (-50€)</option><option value="Bouresse (-50€)">Bouresse (-50€)</option><option value="Brigueil-le-Chantre (-50€)">Brigueil-le-Chantre (-50€)</option><option value="La Chapelle-Viviers (-50€)">La Chapelle-Viviers (-50€)</option><option value="Civaux (-50€)">Civaux (-50€)</option><option value="Coulonges (-25€)">Coulonges (-25€)</option><option value="Fleix (-50€)">Fleix (-50€)</option><option value="Gouex (-50€)">Gouex (-50€)</option><option value="Haims (-30€)">Haims (-30€)</option><option value="L'Isle-Jourdain (-50€)">L'Isle-Jourdain (-50€)</option><option value="Jouhet (-30€)">Jouhet (-30€)</option><option value="Journet (-50€)">Journet (-50€)</option><option value="Lathus-Saint-Remy (-50€)">Lathus-Saint-Remy (-50€)</option><option value="Leignes-sur-fontaine (-50€)">Leignes-sur-fontaine (-50€)</option><option value="Lauthiers (-50€)">Lauthiers (-50€)</option><option value="Lhommaizé (-50€)">Lhommaizé (-50€)</option><option value="Luchapt (-50€)">Luchapt (-50€)</option><option value="Lussac-les-Châteaux (-60€)">Lussac-les-Châteaux (-60€)</option><option value="Mauprévoir (-50€)">Mauprévoir (-50€)</option><option value="Mazerolles (-50€)">Mazerolles (-50€)</option><option value="Millac (-50€)">Millac (-50€)</option><option value="Montmorillon (-50€)">Montmorillon (-50€)</option><option value="Moussac-sur-vienne (-50€)">Moussac-sur-vienne (-50€)</option><option value="Persac (-50€)">Persac (-50€)</option><option value="Pindray (-50€)">Pindray (-50€)</option><option value="Plaisance (-30€)">Plaisance (-30€)</option><option value="Pressac (-50€)">Pressac (-50€)</option><option value="Queaux (-50€)">Queaux (-50€)</option><option value="Saint-Germain (-50€)">Saint-Germain (-50€)</option><option value="Saint-Laurent-de-Jourdes (-50€)">Saint-Laurent-de-Jourdes (-50€)</option><option value="Saint-Léomer (-50€)">Saint-Léomer (-50€)</option><option value="Saint-Pierre-de-Maillé (-30€)">Saint-Pierre-de-Maillé (-30€)</option><option value="Saint-Savin (-50€)">Saint-Savin (-50€)</option><option value="Saint-Martin-L'Ars (-50€)">Saint-Martin-L'Ars (-50€)</option><option value="Saulgé (-50€)">Saulgé (-50€)</option><option value="Sillars (-50€)">Sillars (-50€)</option><option value="Thollet (-50€)">Thollet (-50€)</option><option value="La Trimouille (-100€)">La Trimouille (-100€)</option><option value="Usson-du-poitou (-50€)">Usson-du-poitou (-50€)</option><option value="Valdivienne (-50€)">Valdivienne (-50€)</option><option value="Verrières (-50€)">Verrières (-50€)</option><option value="Le Vigeant (-50€)">Le Vigeant (-50€)</option><option value="Villemort (-50€)">Villemort (-50€)</option><option value="Bonnes (-20€)">Bonnes (-20€)</option></select></div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantAideCommune acf-field acf-field-number acf-field-5b153529ba465" data-name="reductions_montantAideCommune" data-key="field_5b153529ba465" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba465" class="text-md-right">Aide de la commune d'une valeur de</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input readonly="readonly" type="number" id="acf-field_5b153529ba465" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b153529ba465]" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-select af-field-reductions-montantComiteEntreprisePourCalcul acf-field acf-field-select acf-field-5b2105d81db76" data-name="reductions_montantComiteEntreprisePourCalcul" data-key="field_5b2105d81db76" data-type="select"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2105d81db76" class="text-md-right">Comité d'entreprise partenaire</label></div><div class="col-md-7 af-input acf-input"><select id="acf-field_5b2105d81db76" class="form-control" name="acf[field_5b2105d81db76]" data-ui="0" data-ajax="0" data-multiple="0" data-placeholder="Choisir" data-allow_null="1"><option value="" selected="selected" data-i="0">- Choisir -</option><option value="CAES du CNRS">CAES du CNRS</option><option value="InterCAS">InterCAS</option><option value="CSE SAFT">CSE SAFT</option><option value="SATECO">SATECO</option><option value="CASC Grand Poitiers">CASC Grand Poitiers</option><option value="Crédit Agricole Touraine Poitou">Crédit Agricole Touraine Poitou</option><option value="Larnay-Sagesse">Larnay-Sagesse</option><option value="INTERCOS 37">INTERCOS 37</option><option value="ACOLAD">ACOLAD</option><option value="GUILLOT">GUILLOT</option><option value="Amicale centre hospitalier Châtellerault">Amicale centre hospitalier Châtellerault</option><option value="APHV">APHV</option><option value="IMA">IMA</option><option value="ST Microelectronics">ST Microelectronics</option><option value="CerFRANCE">CerFRANCE</option><option value="ADAS INRA">ADAS INRA</option><option value="MFCVL">MFCVL</option><option value="Schneider Electric">Schneider Electric</option><option value="Progecat">Progecat</option><option value="SAFRAN / SNECMA">SAFRAN / SNECMA</option><option value="Pôle Emploi ALPC">Pôle Emploi ALPC</option><option value="Thalès">Thalès</option><option value="Geodis">Geodis</option><option value="MJC La Souterraine">MJC La Souterraine</option><option value="Centre Ouest Céréales">Centre Ouest Céréales</option><option value="SAFRAN Poitiers">SAFRAN Poitiers</option><option value="MJC Amboise">MJC Amboise</option><option value="UDAF 86">UDAF 86</option><option value="PEP 87">PEP 87</option><option value="OREGON TOOL Civray">OREGON TOOL Civray</option><option value="CARSAT">CARSAT</option><option value="MARELLI">MARELLI</option><option value="CSE CEAPC">CSE CEAPC</option><option value="Clinique Fief de Grimoire">Clinique Fief de Grimoire</option><option value="CSE Sanofi Winthrop Industrie">CSE Sanofi Winthrop Industrie</option><option value="Polyclinique de Poitiers">Polyclinique de Poitiers</option><option value="COS Naintré">COS Naintré</option><option value="Danisco France SAS">Danisco France SAS</option><option value="APAJH86">APAJH86</option></select></div></div></div><div id="" class="af-field af-field-type-text af-field-code-ce acf-field acf-field-text acf-field-5c59ac47abae4 acf-hidden" data-name="code_ce" data-key="field_5c59ac47abae4" data-type="text" data-conditions="[[{"field":"field_5b2105d81db76","operator":"!=","value":""}]]" hidden=""><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5c59ac47abae4" class="text-md-right">Code CE</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5c59ac47abae4" class="form-control" name="acf[field_5c59ac47abae4]" disabled=""></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantComiteEntreprise acf-field acf-field-number acf-field-5b2106151db77 d-none" data-name="reductions_montantComiteEntreprise" data-key="field_5b2106151db77" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2106151db77" class="text-md-right">Montant aide CE</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input readonly="readonly" type="number" id="acf-field_5b2106151db77" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b2106151db77]" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-select af-field-reductions-montantPriseEnChargePourCalcul acf-field acf-field-select acf-field-5b2106731db78" data-name="reductions_montantPriseEnChargePourCalcul" data-key="field_5b2106731db78" data-type="select"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b2106731db78" class="text-md-right">Aide de la Communauté de Communes</label></div><div class="col-md-7 af-input acf-input"><select id="acf-field_5b2106731db78" class="form-control" name="acf[field_5b2106731db78]" data-ui="0" data-ajax="0" data-multiple="0" data-placeholder="Choisir" data-allow_null="1"><option value="" selected="selected" data-i="0">- Choisir -</option><option value="CC Vienne et Gartempe (- 50€)">CC Vienne et Gartempe (- 50€)</option></select></div></div></div><div id="" class="af-field af-field-type-file af-field-justificatif-appartenance-ccvg acf-field acf-field-file acf-field-602fcb88daffd af-field-required acf-hidden" data-name="justificatif_appartenance_ccvg" data-key="field_602fcb88daffd" data-type="file" data-conditions="[[{"field":"field_5b2106731db78","operator":"==contains","value":"CC Vienne et Gartempe (- 50€)"}]]" hidden=""><div class="row"><div class="col-sm-12"><div class="big-text text-center"><p style="text-align: left;">Afin de valider l'aide de la CCVG, merci de déposer ici le bon vacances de votre communauté de communes (disponible à la demande sur le site de la Communauté de Communes Vienne et Gartempe)</p></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_602fcb88daffd" class="text-md-right">Justificatif <span class="acf-required">*</span></label></div><div class="col-md-7 af-input acf-input"><div class="acf-file-uploader" data-library="all" data-mime_types="" data-uploader="basic">
<input type="hidden" name="acf[field_602fcb88daffd]" value="" data-name="id" disabled=""> <div class="show-if-value file-wrap">
<div class="file-icon">
<img data-name="icon" src="" alt="">
</div>
<div class="file-info">
<p>
<strong data-name="title"></strong>
</p>
<p>
<strong>Nom du fichier:</strong>
<a data-name="filename" href="" target="_blank"></a>
</p>
<p>
<strong>Poids du fichier:</strong>
<span data-name="filesize"></span>
</p>
</div>
<div class="acf-actions -hover">
<a class="acf-icon -cancel dark" data-name="remove" href="#" title="Enlever"></a>
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<label class="acf-basic-uploader">
<input type="file" data-jcf="{"buttonText": "", "placeholderText": "Ajouter une pièce jointe"}" name="acf[field_602fcb88daffd]" id="acf-field_602fcb88daffd" disabled=""> </label>
</div>
</div>
</div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantPriseEnCharge acf-field acf-field-number acf-field-5b153529ba468" data-name="reductions_montantPriseEnCharge" data-key="field_5b153529ba468" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba468" class="text-md-right">Montant Aide de la Communauté de Communes (Ancien Prise en charge d'un montant de)</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input readonly="readonly" type="number" id="acf-field_5b153529ba468" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b153529ba468]" min="0" max="1005" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-libelleCaf acf-field acf-field-text acf-field-5b226d5e01211" data-name="aides_libelleCaf" data-key="field_5b226d5e01211" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b226d5e01211" class="text-md-right">Aide CAF du département</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b226d5e01211" class="form-control" name="acf[field_5b226d5e01211]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-aides-montantCaf acf-field acf-field-number acf-field-5b226da001213" data-name="aides_montantCaf" data-key="field_5b226da001213" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b226da001213" class="text-md-right">Montant de l'aide CAF</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input type="number" id="acf-field_5b226da001213" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b226da001213]" min="0" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-aides-libelleMSA acf-field acf-field-text acf-field-5b226d8601212" data-name="aides_libelleMSA" data-key="field_5b226d8601212" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b226d8601212" class="text-md-right">Aide MSA du département</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b226d8601212" class="form-control" name="acf[field_5b226d8601212]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-aides-montantMSA acf-field acf-field-number acf-field-5b226daf01214" data-name="aides_montantMSA" data-key="field_5b226daf01214" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b226daf01214" class="text-md-right">Montant de l'aide MSA</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input type="number" id="acf-field_5b226daf01214" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b226daf01214]" min="0" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantJourCafMsa acf-field acf-field-number acf-field-5b153529ba46b d-none" data-name="reductions_montantJourCafMsa" data-key="field_5b153529ba46b" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba46b" class="text-md-right">CAF / MSA</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="number" id="acf-field_5b153529ba46b" class="form-control acf-is-appended" name="acf[field_5b153529ba46b]" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-radio af-field-reductions-montantOptionFidelitePourCalcul acf-field acf-field-radio acf-field-5c1a135583819" data-name="reductions_montantOptionFidelitePourCalcul" data-key="field_5c1a135583819" data-type="radio"><div class="row"><div class="col-sm-12"><div class="big-text text-center"><strong>Tarif « fidélité » / Remise pour le 2e séjour du même enfant <sup>(*)</sup></strong>
<ul>
<li>Option 1 : Réduction de 80 € sur le 3e séjour de la même famille (frère ou sœur)</li>
<li>Option 2 : Réduction de 10% sur le tarif du 2e séjour du même enfant.</li>
</ul>
<sup>(*) Séjours effectués dans une même année civile. Le tarif fidélité et la remise pour le 2ème séjour ne sont pas cumulables.</sup></div></div></div><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5c1a135583819" class="text-md-right">Réductions à cocher</label></div><div class="col-md-7 af-input acf-input"><input type="hidden" name="acf[field_5c1a135583819]"><div class="acf-radio-list acf-bl " data-allow_null="0" data-other_choice="0"><div class="custom-control custom-radio"><input type="radio" class="custom-control-input" id="acf-field_5c1a135583819-pas-doptions" name="acf[field_5c1a135583819]" value="Pas d'options" checked="checked"><label class="custom-control-label" for="acf-field_5c1a135583819-pas-doptions">Pas d'options</label></div><div class="custom-control custom-radio"><input type="radio" class="custom-control-input" id="acf-field_5c1a135583819-option-1-je-deduis-80e" name="acf[field_5c1a135583819]" value="Option 1 (je déduis 80€)"><label class="custom-control-label" for="acf-field_5c1a135583819-option-1-je-deduis-80e">Option 1 (je déduis 80€)</label></div><div class="custom-control custom-radio"><input type="radio" class="custom-control-input" id="acf-field_5c1a135583819-option-2-je-deduis-10" name="acf[field_5c1a135583819]" value="Option 2 (je déduis 10%)"><label class="custom-control-label" for="acf-field_5c1a135583819-option-2-je-deduis-10">Option 2 (je déduis 10%)</label></div></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantOptionFidelite acf-field acf-field-number acf-field-5c1a13588381a" data-name="reductions_montantOptionFidelite" data-key="field_5c1a13588381a" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5c1a13588381a" class="text-md-right">Réduction</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">-</span></div><input readonly="readonly" type="number" id="acf-field_5c1a13588381a" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5c1a13588381a]" min="0" max="1000" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-reductions-libelleAutre acf-field acf-field-text acf-field-5b153529ba470" data-name="reductions_libelleAutre" data-key="field_5b153529ba470" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba470" class="text-md-right">Autre aide (préciser)</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba470" class="form-control" name="acf[field_5b153529ba470]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reductions-montantAutre acf-field acf-field-number acf-field-5b153529ba46d" data-name="reductions_montantAutre" data-key="field_5b153529ba46d" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba46d" class="text-md-right">Montant autre aide</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input type="number" id="acf-field_5b153529ba46d" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b153529ba46d]" min="0" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-reglement-id acf-field acf-field-text acf-field-5b153529ba474 d-none" data-name="reglement_id" data-key="field_5b153529ba474" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba474" class="text-md-right">reglement_id</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba474" class="form-control" name="acf[field_5b153529ba474]"></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reglement-montantChequesVacances acf-field acf-field-number acf-field-5b153529ba479" data-name="reglement_montantChequesVacances" data-key="field_5b153529ba479" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba479" class="text-md-right">Chèques-vacances d'une valeur de</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><div class="input-group-prepend"><span class="input-group-text">−</span></div><input type="number" id="acf-field_5b153529ba479" class="form-control acf-is-prepended acf-is-appended" name="acf[field_5b153529ba479]" min="0" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-number af-field-reglement-montantCheque acf-field acf-field-number acf-field-5b153529ba476" data-name="reglement_montantCheque" data-key="field_5b153529ba476" data-type="number"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba476" class="text-md-right">Montant final</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input readonly="readonly" type="number" id="acf-field_5b153529ba476" class="form-control acf-is-appended" name="acf[field_5b153529ba476]" min="0" step="any"><div class="input-group-append"><span class="input-group-text">€</span></div></div></div></div></div><div id="" class="af-field af-field-type-text af-field-synchronisation acf-field acf-field-text acf-field-5b153529ba481 d-none" data-name="synchronisation" data-key="field_5b153529ba481" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba481" class="text-md-right">Synchronisation</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba481" class="form-control" name="acf[field_5b153529ba481]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-remarques acf-field acf-field-text acf-field-5b153529ba47e d-none" data-name="remarques" data-key="field_5b153529ba47e" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b153529ba47e" class="text-md-right">Remarques</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b153529ba47e" class="form-control" name="acf[field_5b153529ba47e]"></div></div></div></div><div id="" class="af-field af-field-type-text af-field-files acf-field acf-field-text acf-field-5b44b797d2520" data-name="files" data-key="field_5b44b797d2520" data-type="text"><div class="row"><div class="col-md-5 col-form-label af-label acf-label"><label for="acf-field_5b44b797d2520" class="text-md-right">Ajouter des fichiers</label></div><div class="col-md-7 af-input acf-input"><div class="input-group"><input type="text" id="acf-field_5b44b797d2520" class="form-control" name="acf[field_5b44b797d2520]"></div></div></div></div><div id="" class="af-field af-field-type-true-false af-field-certification acf-field acf-field-true-false acf-field-5b9fa568153ac af-field-required" data-name="certification" data-key="field_5b9fa568153ac" data-type="true_false"><div class="row"><div class="col-md-12 col-form-label af-label acf-label"><label for="acf-field_5b9fa568153ac" class="text-md-center">Je certifie être le responsable légal de l’enfant, certifie exactes les informations mentionnées dans ce formulaire et déclare avoir pris connaissance des conditions générales d’inscription. Je valide ainsi ma demande d’inscription. <span class="acf-required">*</span></label></div><div class="offset-md-5 col-md-7 af-input acf-input"><div class="acf-true-false">
<input type="hidden" name="acf[field_5b9fa568153ac]" value="0"> <label>
<input type="checkbox" id="acf-field_5b9fa568153ac" name="acf[field_5b9fa568153ac]" value="1" class="form-control acf-switch-input" autocomplete="off">
<div class="acf-switch"><span class="acf-switch-on" style="min-width: 23.8333px;">Oui</span><span class="acf-switch-off" style="min-width: 23.8333px;">Non</span><div class="acf-switch-slider"></div></div> </label>
</div>
</div></div><div class="row"><div class="col-sm-12"><div class="big-text text-center"><h4 style="text-align: left;">Conditions générales d’inscription</h4>
<p style="text-align: left;">Votre inscription sera prise en compte après réception de toutes les pièces justificatives demandées.<br>
En cas d’annulation de votre part (à signifier par écrit), une partie du prix du séjour reste acquis à l’association : un mois avant : 25 %, entre 15 jours et un mois : 50 %, moins de 15 jours avant : 100 %.<br>
En cas d’annulation par l’association (en cas d’insuffisance d’inscriptions) nous vous proposerons soit un autre séjour de même durée, soit le remboursement de la somme versée.<br>
En cas d’annulation en raison de la pandémie COVID-19, les séjours seronts intégralement remboursés.<br>
Dans le cadre d’un séjour en camps d’été à Lathus, mon enfant peut être susceptible :</p>
<ul>
<li style="text-align: left;">d’être transporté dans les véhicules du CPA Lathus ou d’une société de transport en commun ;</li>
<li style="text-align: left;">de participer aux sorties, aux visites et aux activités sportives effectuées dans le cadre des camps d’été ;</li>
<li style="text-align: left;">d’être photographié individuellement ou en groupe dans le cadre des activités des camps (pour diffusion éventuelle sur les supports de communication du CPA Lathus ou de la presse locale).</li>
</ul>
<p><strong>L’inscription ne sera définitive qu’une fois validée par le secrétariat des camps, nous reviendrons vers vous si nécessaire.</strong></p>
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