{"id":1456,"date":"2026-04-23T01:07:05","date_gmt":"2026-04-22T23:07:05","guid":{"rendered":"https:\/\/selfdefense-lorient.com\/?page_id=1456"},"modified":"2026-04-23T01:07:05","modified_gmt":"2026-04-22T23:07:05","slug":"formulaire-dinscription","status":"publish","type":"page","link":"https:\/\/selfdefense-lorient.com\/index.php\/formulaire-dinscription\/","title":{"rendered":"formulaire d&rsquo;inscription"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1455-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"1455\">\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\/1456#wpcf7-f1455-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1455\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1455-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"form-grid\">\n\t<div class=\"col\">\n\t\t<p><label>Nom*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>Pr\u00e9nom*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"prenom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"prenom\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>Date de naissance*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"naissance\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"naissance\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>T\u00e9l\u00e9phone*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"telephone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"telephone\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col\">\n\t\t<p><label>Email*<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\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>Adresse*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adresse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adresse\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>Code postal*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"code_postal\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"code_postal\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>Ville*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ville\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ville\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr \/>\n<div class=\"form-grid\">\n\t<div class=\"col\">\n\t\t<p><label>Ant\u00e9c\u00e9dents m\u00e9dicaux*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"antecedents\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"antecedents\"><\/textarea><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col\">\n\t\t<p><label>Personne \u00e0 pr\u00e9venir*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urgence_nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"urgence_nom\" \/><\/span><\/label>\n\t\t<\/p>\n\t\t<p><label>T\u00e9l\u00e9phone urgence*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urgence_tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"urgence_tel\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr \/>\n<p><label>Date d\u2019inscription*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"inscription\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"inscription\" \/><\/span><\/label>\n<\/p>\n<p>Choix de l\u2019abonnement*\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"abonnement\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"abonnement[]\" value=\"2 cours \/ semaine \u2013 599\u20ac (59,90\u20ac\/mois)\" \/><span class=\"wpcf7-list-item-label\">2 cours \/ semaine \u2013 599\u20ac (59,90\u20ac\/mois)<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"abonnement[]\" value=\"1 cours \/ semaine \u2013 399\u20ac (39,90\u20ac\/mois)\" \/><span class=\"wpcf7-list-item-label\">1 cours \/ semaine \u2013 399\u20ac (39,90\u20ac\/mois)<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<hr \/>\n<p>\ud83d\udcce Pi\u00e8ces obligatoires\n<\/p>\n<p><label>RIB Mandat SEPA*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"rib\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"rib\" \/><\/span><\/label>\n<\/p>\n<p><label>Certificat m\u00e9dical*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"certificat\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"certificat\" \/><\/span><\/label>\n<\/p>\n<p><label>Attestation RC*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"assurance\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"assurance\" \/><\/span><\/label>\n<\/p>\n<p><label>D\u00e9charge responsabilit\u00e9*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"decharge\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"decharge\" \/><\/span><\/label>\n<\/p>\n<p><label>R\u00e8glement int\u00e9rieur*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reglement\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"reglement\" \/><\/span><\/label>\n<\/p>\n<hr \/>\n<p><label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-420\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-420[]\" value=\"Je confirme \u00eatre majeur et m\u2019engage \u00e0 acheter la tenue officielle.\" \/><span class=\"wpcf7-list-item-label\">Je confirme \u00eatre majeur et m\u2019engage \u00e0 acheter la tenue officielle.<\/span><\/label><\/span><\/span><\/span><br \/>\n<\/label>\n<\/p>\n<p>\ud83d\udd8a\ufe0f Signature \u00e9lectronique*\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Signature-electronique\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Signature-electronique\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Je signe \u00e9lectroniquement ce formulaire et confirme l\u2019exactitude des informations.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>---\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Valider mon inscription\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1456","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>formulaire d&#039;inscription - SELF-DEFENSE LORIENT<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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