BOXING

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BOXINGMoses2021-05-12T21:46:05+00:00

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<div class="wpforms-container wpforms-container-full" id="wpforms-8032"><form id="wpforms-form-8032" class="wpforms-validate wpforms-form" data-formid="8032" method="post" enctype="multipart/form-data" action="/cours/elevate-boxing/" data-token="8a9ec525ecf6beaf1e7081e490ceec5a"><noscript class="wpforms-error-noscript">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.</noscript><div class="wpforms-field-container"><div id="wpforms-8032-field_1-container" class="wpforms-field wpforms-field-checkbox wpforms-list-inline" data-field-id="1"><label class="wpforms-field-label" for="wpforms-8032-field_1">Choisissez votre salle de sport <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_1" class="wpforms-randomize wpforms-field-required" data-choice-limit="1"><li class="choice-1 depth-1"><input type="checkbox" id="wpforms-8032-field_1_1" data-rule-check-limit="true" name="wpforms[fields][1][]" value="Chartrons" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_1_1">Chartrons</label></li><li class="choice-2 depth-1"><input type="checkbox" id="wpforms-8032-field_1_2" data-rule-check-limit="true" name="wpforms[fields][1][]" value="Saint-Genes" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_1_2">Saint-Genes</label></li><li class="choice-3 depth-1"><input type="checkbox" id="wpforms-8032-field_1_3" data-rule-check-limit="true" name="wpforms[fields][1][]" value="Bassin à Flots" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_1_3">Bassin à Flots</label></li></ul></div><div id="wpforms-8032-field_4-container" class="wpforms-field wpforms-field-radio wpforms-list-inline" data-field-id="4"><label class="wpforms-field-label" for="wpforms-8032-field_4">Habitez-vous ou travaillez-vous près d’un des clubs ? <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_4" class="wpforms-randomize wpforms-field-required"><li class="choice-1 depth-1"><input type="radio" id="wpforms-8032-field_4_1" name="wpforms[fields][4]" value="Oui " required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_4_1">Oui </label></li><li class="choice-2 depth-1"><input type="radio" id="wpforms-8032-field_4_2" name="wpforms[fields][4]" value="Non" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_4_2">Non</label></li></ul></div><div id="wpforms-8032-field_5-container" class="wpforms-field wpforms-field-radio wpforms-list-inline" data-field-id="5"><label class="wpforms-field-label" for="wpforms-8032-field_5">Connaissez-vous un membre de notre club ? <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_5" class="wpforms-randomize wpforms-field-required"><li class="choice-1 depth-1"><input type="radio" id="wpforms-8032-field_5_1" name="wpforms[fields][5]" value="Oui" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_5_1">Oui</label></li><li class="choice-2 depth-1"><input type="radio" id="wpforms-8032-field_5_2" name="wpforms[fields][5]" value="Non" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_5_2">Non</label></li></ul></div><div id="wpforms-8032-field_18-container" class="wpforms-field wpforms-field-checkbox wpforms-list-inline" data-field-id="18"><label class="wpforms-field-label" for="wpforms-8032-field_18">Quand êtes-vous prêt à commencer ? <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_18" class="wpforms-randomize wpforms-field-required" data-choice-limit="1"><li class="choice-1 depth-1"><input type="checkbox" id="wpforms-8032-field_18_1" data-rule-check-limit="true" name="wpforms[fields][18][]" value="Demain" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_18_1">Demain</label></li><li class="choice-2 depth-1"><input type="checkbox" id="wpforms-8032-field_18_2" data-rule-check-limit="true" name="wpforms[fields][18][]" value="La semaine prochaine" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_18_2">La semaine prochaine</label></li><li class="choice-3 depth-1"><input type="checkbox" id="wpforms-8032-field_18_3" data-rule-check-limit="true" name="wpforms[fields][18][]" value="Je réfléchis" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_18_3">Je réfléchis</label></li></ul></div><div id="wpforms-8032-field_19-container" class="wpforms-field wpforms-field-checkbox wpforms-list-inline" data-field-id="19"><label class="wpforms-field-label" for="wpforms-8032-field_19">À quel moment êtes-vous disponible pour qu’un coach puisse vous appeler pour vous aider à reprendre le sport? <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_19" class="wpforms-randomize wpforms-field-required" data-choice-limit="3"><li class="choice-1 depth-1"><input type="checkbox" id="wpforms-8032-field_19_1" data-rule-check-limit="true" name="wpforms[fields][19][]" value="Matin" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_19_1">Matin</label></li><li class="choice-2 depth-1"><input type="checkbox" id="wpforms-8032-field_19_2" data-rule-check-limit="true" name="wpforms[fields][19][]" value="Midi" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_19_2">Midi</label></li><li class="choice-3 depth-1"><input type="checkbox" id="wpforms-8032-field_19_3" data-rule-check-limit="true" name="wpforms[fields][19][]" value="Soir" required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_19_3">Soir</label></li></ul></div><div id="wpforms-8032-field_7-container" class="wpforms-field wpforms-field-text" data-field-id="7"><label class="wpforms-field-label" for="wpforms-8032-field_7">Quel est votre objectif précis? <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8032-field_7" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][7]" required></div><div id="wpforms-8032-field_8-container" class="wpforms-field wpforms-field-text" data-field-id="8"><label class="wpforms-field-label" for="wpforms-8032-field_8">Quel est votre profession? <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8032-field_8" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][8]" required></div><div id="wpforms-8032-field_21-container" class="wpforms-field wpforms-field-name" data-field-id="21"><label class="wpforms-field-label" for="wpforms-8032-field_21">Nom <span class="wpforms-required-label">*</span></label><div class="wpforms-field-row wpforms-field-medium"><div class="wpforms-field-row-block wpforms-first wpforms-one-half"><input type="text" id="wpforms-8032-field_21" class="wpforms-field-name-first wpforms-field-required" name="wpforms[fields][21][first]" placeholder="Prénom" required><label for="wpforms-8032-field_21" class="wpforms-field-sublabel after wpforms-sublabel-hide">Prénom</label></div><div class="wpforms-field-row-block wpforms-one-half"><input type="text" id="wpforms-8032-field_21-last" class="wpforms-field-name-last wpforms-field-required" name="wpforms[fields][21][last]" placeholder="Nom" required><label for="wpforms-8032-field_21-last" class="wpforms-field-sublabel after wpforms-sublabel-hide">Nom</label></div></div></div><div id="wpforms-8032-field_11-container" class="wpforms-field wpforms-field-email" data-field-id="11"><label class="wpforms-field-label" for="wpforms-8032-field_11">Email <span class="wpforms-required-label">*</span></label><input type="email" id="wpforms-8032-field_11" class="wpforms-field-medium wpforms-field-required" name="wpforms[fields][11]" required></div><div id="wpforms-8032-field_22-container" class="wpforms-field wpforms-field-phone" data-field-id="22"><label class="wpforms-field-label" for="wpforms-8032-field_22">Téléphone <span class="wpforms-required-label">*</span></label><input type="tel" id="wpforms-8032-field_22" class="wpforms-field-small wpforms-field-required wpforms-smart-phone-field" data-rule-smart-phone-field="true" name="wpforms[fields][22]" required></div><div id="wpforms-8032-field_14-container" class="wpforms-field wpforms-field-gdpr-checkbox" data-field-id="14"><label class="wpforms-field-label" for="wpforms-8032-field_14">Accord RGPD <span class="wpforms-required-label">*</span></label><ul id="wpforms-8032-field_14" class="wpforms-field-required"><li class="choice-1"><input type="checkbox" id="wpforms-8032-field_14_1" name="wpforms[fields][14][]" value="Je consens à ce que ce site stocke mes informations envoyées afin qu’ils puissent répondre à ma requête." required ><label class="wpforms-field-label-inline" for="wpforms-8032-field_14_1">Je consens à ce que ce site stocke mes informations envoyées afin qu’ils puissent répondre à ma requête.</label></li></ul></div></div><div class="wpforms-submit-container" ><input type="hidden" name="wpforms[id]" value="8032"><input type="hidden" name="wpforms[author]" value="1"><input type="hidden" name="wpforms[post_id]" value="7970"><button type="submit" name="wpforms[submit]" class="wpforms-submit " id="wpforms-submit-8032" value="wpforms-submit" aria-live="assertive" data-alt-text="Envoi..." data-submit-text="Valider">Valider</button></div></form></div>

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