{"id":4732,"date":"2024-01-25T11:41:02","date_gmt":"2024-01-25T11:41:02","guid":{"rendered":"https:\/\/www.jeunesseabruxelles.be\/site\/?page_id=4732"},"modified":"2026-03-02T08:23:43","modified_gmt":"2026-03-02T08:23:43","slug":"inscription-a-une-plaine-de-vacances-automne-2025","status":"publish","type":"page","link":"https:\/\/www.jeunesseabruxelles.be\/site\/activites-de-vacances\/plaines\/inscription-a-une-plaine-de-vacances-automne-2025\/","title":{"rendered":"INSCRIPTION \u00c0 UNE PLAINE DE VACANCES \u2013 Printemps 2026"},"content":{"rendered":"\n<div class=\"wpforms-container \" id=\"wpforms-6391\"><form id=\"wpforms-form-6391\" class=\"wpforms-validate wpforms-form\" data-formid=\"6391\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/site\/wp-json\/wp\/v2\/pages\/4732?wpforms_form_id=6391\" data-token=\"3de99aaeee092f7f4ab3ef0099a9dda4\"><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div class=\"wpforms-page-indicator progress\" data-indicator=\"progress\" data-indicator-color=\"#72b239\" data-scroll=\"1\"><span class=\"wpforms-page-indicator-page-title\" ><\/span><span class=\"wpforms-page-indicator-page-title-sep\" style=\"display:none;\"> - <\/span><span class=\"wpforms-page-indicator-steps\">Step <span class=\"wpforms-page-indicator-steps-current\">1<\/span> of 3<\/span><div class=\"wpforms-page-indicator-page-progress-wrap\"><div class=\"wpforms-page-indicator-page-progress\" style=\"width:33.333333333333%;background-color:#72b239;\"><\/div><\/div><\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \"><div id=\"wpforms-6391-field_75-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"75\"><\/div><div id=\"wpforms-6391-field_39-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"39\"><h3 id=\"wpforms-6391-field_39\" name=\"wpforms[fields][39]\">REMARQUES IMPORTANTES<\/h3><div class=\"wpforms-field-description\"><strong>Conditions d'inscription:<\/strong> <ul> <li>Seul le parent ou tuteur de l\u2019enfant peut inscrire celui-ci \u00e0 nos activit\u00e9s de vacances. <\/li> <li>Nous invitons les institutions \u00e0 prendre contact avec le secr\u00e9tariat des activit\u00e9s de vacances pour formuler leur(s) demande(s) d\u2019inscription(s) ou consulter le lien suivant : <a href=\"http:\/\/www.jeunesseabruxelles.be\/site\/inscription-via-une-institution\/\" target=\"_blank\">Inscription via une institution<\/a> <\/li> <\/ul> <strong>Comment s'inscrire :<\/strong> <ul> <li>Compl\u00e9ter le formulaire en ligne ci-dessous  et faites-le nous parvenir au plus tard \u00e0 la date indiqu\u00e9e ci-dessous. <\/li><li>Un dossier de confirmation sera envoy\u00e9 \u00e0 chaque participant. Vous y trouverez le bulletin de virement pour effectuer le paiement ainsi que plus de pr\u00e9cisions concernant le mat\u00e9riel \u00e0 apporter. Dans ce courrier, vous trouverez \u00e9galement une fiche sant\u00e9 et une autorisation parentale. Ces documents doivent \u00eatre compl\u00e9t\u00e9s et remis le premier jour au responsable de l'accueil.<\/li> <\/ul> <strong>Conditions d\u2019annulation : <\/strong><br \/> D\u00e8s l\u2019instant o\u00f9 vous ne souhaitez plus maintenir votre inscription, il est imp\u00e9ratif de le faire savoir par <strong> \u00e9crit <\/strong> au secr\u00e9tariat des activit\u00e9s de vacances <strong> minimum 5 jours ouvrables avant la date du d\u00e9but de l\u2019activit\u00e9 <\/strong>, que le paiement ait ou non \u00e9t\u00e9 effectu\u00e9, que l\u2019inscription ait ou non \u00e9t\u00e9 confirm\u00e9e. Dans ce cas, aucun frais ne vous seront r\u00e9clam\u00e9s. <br \/><br \/> Dans le cas contraire*, des frais vous seront factur\u00e9s : <br \/>\u00b7 Pour une semaine de 5 jours : 60\u20ac pour le tarif plein, 20\u20ac pour le tarif pr\u00e9f\u00e9rentiel ou 10\u20ac pour le tarif social ; <br \/>\u00b7 Pour une semaine de 4 jours : 48\u20ac pour le tarif plein, 16\u20ac pour le tarif pr\u00e9f\u00e9rentiel ou 8\u20ac pour le tarif social ; <br \/>\u00b7 Pour une semaine de 3 jours : 36\u20ac pour le tarif plein, 12\u20ac pour le tarif pr\u00e9f\u00e9rentiel ou 6\u20ac pour le tarif social. <br \/>Par ailleurs, l\u2019\u00e9ventuelle inscription aux semaines suivantes ou \u00e0 d\u2019autres activit\u00e9s (stages - s\u00e9jours) est automatiquement annul\u00e9e. <br \/><br \/> *<i>sauf sur pr\u00e9sentation d\u2019un certificat m\u00e9dical au secr\u00e9tariat des activit\u00e9s de vacances.<\/i> <br \/><br \/> <center> <strong>Merci de compl\u00e9ter un formulaire par enfant.<\/strong> <ul><li><br \/><\/li> <\/ul><strong>Inscription obligatoire avant le 6 avril 2026*.<\/strong><i>*Conform\u00e9ment \u00e0 l'article 7 du R\u00e8glement g\u00e9n\u00e9ral des Activit\u00e9s de vacances de la Ville de Bruxelles, apr\u00e8s cette date limite, des inscriptions peuvent \u00eatre valid\u00e9es :<\/i><i> - en fonction des disponibilit\u00e9s dans chaque centre de vacances (par exemple, en cas de d\u00e9sistement d'autres enfants) ;<\/i><i> - en suivant l'ordre chronologique de r\u00e9ception des inscriptions hors d\u00e9lais dans notre service.<\/i><\/center><\/div><\/div><div id=\"wpforms-6391-field_1-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"1\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-6391-field_1\">Conditions g\u00e9n\u00e9rales <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_1\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_1_1\" name=\"wpforms[fields][1][]\" value=\"J\u2019ai lu et j\u2019accepte les conditions g\u00e9n\u00e9rales d\u2019inscription aux activit\u00e9s de vacances organis\u00e9es par Jeunesse \u00e0 Bruxelles asbl - &lt;a href=&quot;http:\/\/www.jeunesseabruxelles.be\/site\/activites-de-vacances\/inscription-en-ligne\/conditions-generales-inscriptions&quot; target=&quot;_blank&quot;&gt;(lire ici)&lt;\/a&gt;\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_1_1\">J\u2019ai lu et j\u2019accepte les conditions g\u00e9n\u00e9rales d\u2019inscription aux activit\u00e9s de vacances organis\u00e9es par Jeunesse \u00e0 Bruxelles asbl - <a href=\"http:\/\/www.jeunesseabruxelles.be\/site\/activites-de-vacances\/inscription-en-ligne\/conditions-generales-inscriptions\" target=\"_blank\">(lire ici)<\/a><\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_32-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"32\"><h3 id=\"wpforms-6391-field_32\" name=\"wpforms[fields][32]\">LES COORDONNEES DES PARENTS OU DE LA PERSONNE EN CHARGE DE L&#039;ENFANT<\/h3><\/div><div id=\"wpforms-6391-field_73-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"73\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_73\">Pr\u00e9nom et Nom de la personne en charge de l&#039;enfant <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-6391-field_73\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][73][first]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-6391-field_73\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-6391-field_73-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][73][last]\" placeholder=\"Nom\" required><label for=\"wpforms-6391-field_73-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Nom<\/label><\/div><\/div><\/div><div id=\"wpforms-6391-field_97-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"97\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_97\">Num\u00e9ro de registre national de la personne en charge de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_97\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][97]\" placeholder=\"NISS\" required><\/div><div id=\"wpforms-6391-field_83-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"83\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_83\">Coordonn\u00e9es de la personne en charge de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_83\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][83]\" placeholder=\"Adresse + num\u00e9ro\" required><\/div><div id=\"wpforms-6391-field_92-container\" class=\"wpforms-field wpforms-field-number wpforms-conditional-trigger\" data-field-id=\"92\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-6391-field_92\">Code Postal<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-6391-field_92\" class=\"wpforms-field-small\" name=\"wpforms[fields][92]\" placeholder=\"Code Postal\" ><\/div><div id=\"wpforms-6391-field_84-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"84\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-6391-field_84\">Ville <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_84\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][84]\" placeholder=\"Ville\" required><\/div><div id=\"wpforms-6391-field_6-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_6\">T\u00e9l\u00e9phone fixe domicle<\/label><input type=\"tel\" id=\"wpforms-6391-field_6\" class=\"wpforms-field-medium\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][6]\" ><div class=\"wpforms-field-description\">T\u00e9l\u00e9phone fixe domicle<\/div><\/div><div id=\"wpforms-6391-field_34-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_34\">T\u00e9l\u00e9phone portable personne en charge 1 <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-6391-field_34\" class=\"wpforms-field-medium wpforms-field-required\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][34]\" required><div class=\"wpforms-field-description\">T\u00e9l\u00e9phone portable personne en charge 1<\/div><\/div><div id=\"wpforms-6391-field_35-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_35\">T\u00e9l\u00e9phone bureau personne en charge 1<\/label><input type=\"tel\" id=\"wpforms-6391-field_35\" class=\"wpforms-field-medium\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][35]\" ><div class=\"wpforms-field-description\">T\u00e9l\u00e9phone bureau personne en charge 1<\/div><\/div><div id=\"wpforms-6391-field_11-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_11\">Votre adresse Email <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"email\" id=\"wpforms-6391-field_11\" class=\"wpforms-field-required wpforms-field-email-primary\" name=\"wpforms[fields][11][primary]\" required><label for=\"wpforms-6391-field_11\" class=\"wpforms-field-sublabel after \">E-mail<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"email\" id=\"wpforms-6391-field_11-secondary\" class=\"wpforms-field-email-secondary wpforms-field-required\" data-rule-confirm=\"#wpforms-6391-field_11\" name=\"wpforms[fields][11][secondary]\" required><label for=\"wpforms-6391-field_11-secondary\" class=\"wpforms-field-sublabel after \">Confirmez l\u2019e-mail<\/label><\/div><\/div><\/div><div id=\"wpforms-6391-field_86-container\" class=\"wpforms-field wpforms-field-radio wpforms-conditional-trigger\" data-field-id=\"86\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_86\">Une deuxi\u00e8me personne est-elle en charge de l&#039;enfant? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_86\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_86_1\" name=\"wpforms[fields][86]\" value=\"Oui\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_86_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_86_2\" name=\"wpforms[fields][86]\" value=\"Non\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_86_2\">Non<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_79-container\" class=\"wpforms-field wpforms-field-name wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"79\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_79\">Pr\u00e9nom et Nom de la 2\u00e8me personne en charge de l&#039;enfant <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-6391-field_79\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][79][first]\" placeholder=\"Pr\u00e9nom\" required><label for=\"wpforms-6391-field_79\" class=\"wpforms-field-sublabel after \">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-6391-field_79-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][79][last]\" placeholder=\"Nom\" required><label for=\"wpforms-6391-field_79-last\" class=\"wpforms-field-sublabel after \">Nom<\/label><\/div><\/div><\/div><div id=\"wpforms-6391-field_98-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"98\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_98\">Num\u00e9ro de registre national de la 2\u00e8me personne en charge de l&#039;enfant (copier)<\/label><input type=\"text\" id=\"wpforms-6391-field_98\" class=\"wpforms-field-medium\" name=\"wpforms[fields][98]\" placeholder=\"NISS\" ><\/div><div id=\"wpforms-6391-field_36-container\" class=\"wpforms-field wpforms-field-phone wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"36\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_36\">T\u00e9l\u00e9phone portable personne en charge 2 <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-6391-field_36\" class=\"wpforms-field-medium wpforms-field-required\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][36]\" required><div class=\"wpforms-field-description\">T\u00e9l\u00e9phone portable personne en charge 2<\/div><\/div><div id=\"wpforms-6391-field_37-container\" class=\"wpforms-field wpforms-field-phone wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"37\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_37\">T\u00e9l\u00e9phone bureau personne en charge 2<\/label><input type=\"tel\" id=\"wpforms-6391-field_37\" class=\"wpforms-field-medium\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][37]\" ><div class=\"wpforms-field-description\">T\u00e9l\u00e9phone bureau personne en charge 2<\/div><\/div><div id=\"wpforms-6391-field_87-container\" class=\"wpforms-field wpforms-field-radio wpforms-conditional-trigger\" data-field-id=\"87\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_87\">Une des personnes en charge est-elle membre du personnel communal de la Ville de Bruxelles?  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_87\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_87_1\" name=\"wpforms[fields][87]\" value=\"Oui\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_87_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_87_2\" name=\"wpforms[fields][87]\" value=\"Non\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_87_2\">Non<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_13-container\" class=\"wpforms-field wpforms-field-file-upload wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"13\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_13\">Si oui, veuillez joindre une copie de la carte de la Ville ( pdf \/ jpg )<\/label><div\n\t\tclass=\"wpforms-uploader\"\n\t\tdata-field-id=\"13\"\n\t\tdata-form-id=\"6391\"\n\t\tdata-input-name=\"wpforms_6391_13\"\n\t\tdata-extensions=\"pdf,jpg,jpeg,png,gif\"\n\t\tdata-max-size=\"5242880\"\n\t\tdata-max-file-number=\"1\"\n\t\tdata-post-max-size=\"2097152\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg viewBox=\"0 0 1024 1024\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"#b1b1b1\" aria-hidden=\"true\">\n\t\t\t<path d=\"M885.2 446.3l-.2-.8-112.2-285.1c-5-16.1-19.9-27.2-36.8-27.2H281.2c-17 0-32.1 11.3-36.9 27.6L139.4 443l-.3.7-.2.8c-1.3 4.9-1.7 9.9-1 14.8-.1 1.6-.2 3.2-.2 4.8V830a60.9 60.9 0 0 0 60.8 60.8h627.2c33.5 0 60.8-27.3 60.9-60.8V464.1c0-1.3 0-2.6-.1-3.7.4-4.9 0-9.6-1.3-14.1zm-295.8-43l-.3 15.7c-.8 44.9-31.8 75.1-77.1 75.1-22.1 0-41.1-7.1-54.8-20.6S436 441.2 435.6 419l-.3-15.7H229.5L309 210h399.2l81.7 193.3H589.4zm-375 76.8h157.3c24.3 57.1 76 90.8 140.4 90.8 33.7 0 65-9.4 90.3-27.2 22.2-15.6 39.5-37.4 50.7-63.6h156.5V814H214.4V480.1z\"><\/path>\n\t\t<\/svg>\n\t\t<span class=\"modern-title\">Click or drag a file to this area to upload.<\/span>\n\n\t\t\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-6391-field_13\"\n\t\tname=\"wpforms_6391_13\" \t\tvalue=\"\">\n<\/div><div id=\"wpforms-6391-field_74-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"74\"><div class=\"wpforms-clear wpforms-pagebreak-right\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"1\" data-formid=\"6391\" disabled>Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2  \" style=\"display:none;\"><div id=\"wpforms-6391-field_38-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"38\"><h3 id=\"wpforms-6391-field_38\" name=\"wpforms[fields][38]\">LES COORDONNEES DE L&#039;ENFANT<\/h3><\/div><div id=\"wpforms-6391-field_113-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"113\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_113\">Mon enfant a d\u00e9j\u00e0 particip\u00e9 aux activit\u00e9s de vacances chez Jeunesse \u00e0 Bruxelles<\/label><select id=\"wpforms-6391-field_113\" class=\"wpforms-field-medium\" name=\"wpforms[fields][113]\"><option value=\"Oui\" >Oui<\/option><option value=\"Non\" >Non<\/option><\/select><\/div><div id=\"wpforms-6391-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_20\">Nom de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_20\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][20]\" required><\/div><div id=\"wpforms-6391-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_21\">Pr\u00e9nom de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_21\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][21]\" required><\/div><div id=\"wpforms-6391-field_99-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"99\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_99\">Num\u00e9ro de registre national de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_99\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][99]\" placeholder=\"NISS\" required><\/div><div id=\"wpforms-6391-field_22-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_22\">N\u00e9(e) le <span class=\"wpforms-required-label\">*<\/span><\/label><select name=\"wpforms[fields][22][date][d]\" id=\"wpforms-field_22-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><span class=\"wpforms-field-date-time-date-sep\">\/<\/span><select name=\"wpforms[fields][22][date][m]\" id=\"wpforms-field_22-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><span class=\"wpforms-field-date-time-date-sep\">\/<\/span><select name=\"wpforms[fields][22][date][y]\" id=\"wpforms-field_22-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><div id=\"wpforms-6391-field_100-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"100\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_100\">\u00c2ge de l&#039;enfant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_100\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][100]\" required><\/div><div id=\"wpforms-6391-field_88-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"88\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_88\">Sexe <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_88\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_88_1\" name=\"wpforms[fields][88]\" value=\"F\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_88_1\">F<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-6391-field_88_2\" name=\"wpforms[fields][88]\" value=\"M\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_88_2\">M<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_94-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"94\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_94\">Le num\u00e9ro de client de la mutuelle (vignette) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_94\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][94]\" required><\/div><div id=\"wpforms-6391-field_41-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"41\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_41\">L&#039;\u00e9cole fr\u00e9quent\u00e9e <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_41\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][41]\" placeholder=\"Nom de l&#039;\u00e9tablissement\" required><\/div><div id=\"wpforms-6391-field_96-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"96\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_96\">Section <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_96\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_96_1\" name=\"wpforms[fields][96][]\" value=\"Maternelle \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_96_1\">Maternelle <\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_96_2\" name=\"wpforms[fields][96][]\" value=\"Primaire\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_96_2\">Primaire<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_104-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"104\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_104\">Type d&#039;enseignement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_104\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_104_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][104][]\" value=\"G\u00e9n\u00e9ral\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_104_1\">G\u00e9n\u00e9ral<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_104_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][104][]\" value=\"Sp\u00e9cialis\u00e9\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_104_2\">Sp\u00e9cialis\u00e9<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_42-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_42\">Adresse de l&#039;\u00e9cole <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_42\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][42]\" placeholder=\"Adresse, num\u00e9ro et code postal de l&#039;\u00e9cole\" required><\/div><div id=\"wpforms-6391-field_90-container\" class=\"wpforms-field wpforms-field-file-upload wpforms-conditional-field wpforms-conditional-hide\" data-field-id=\"90\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_90\">Pour les personnes domicili\u00e9es en dehors du territoire communal de la Ville de Bruxelles (1000 - 1020 - 1120 - 1130) mais dont l&#039;enfant fr\u00e9quente une \u00e9cole situ\u00e9e sur ce m\u00eame territoire communal, une preuve d&#039;inscription ou une attestation de fr\u00e9quentation scolaire est n\u00e9cessaire <span class=\"wpforms-required-label\">*<\/span><\/label><div\n\t\tclass=\"wpforms-uploader\"\n\t\tdata-field-id=\"90\"\n\t\tdata-form-id=\"6391\"\n\t\tdata-input-name=\"wpforms_6391_90\"\n\t\tdata-extensions=\"pdf,jpg,jpeg,png,gif\"\n\t\tdata-max-size=\"5242880\"\n\t\tdata-max-file-number=\"1\"\n\t\tdata-post-max-size=\"2097152\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg viewBox=\"0 0 1024 1024\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"#b1b1b1\" aria-hidden=\"true\">\n\t\t\t<path d=\"M885.2 446.3l-.2-.8-112.2-285.1c-5-16.1-19.9-27.2-36.8-27.2H281.2c-17 0-32.1 11.3-36.9 27.6L139.4 443l-.3.7-.2.8c-1.3 4.9-1.7 9.9-1 14.8-.1 1.6-.2 3.2-.2 4.8V830a60.9 60.9 0 0 0 60.8 60.8h627.2c33.5 0 60.8-27.3 60.9-60.8V464.1c0-1.3 0-2.6-.1-3.7.4-4.9 0-9.6-1.3-14.1zm-295.8-43l-.3 15.7c-.8 44.9-31.8 75.1-77.1 75.1-22.1 0-41.1-7.1-54.8-20.6S436 441.2 435.6 419l-.3-15.7H229.5L309 210h399.2l81.7 193.3H589.4zm-375 76.8h157.3c24.3 57.1 76 90.8 140.4 90.8 33.7 0 65-9.4 90.3-27.2 22.2-15.6 39.5-37.4 50.7-63.6h156.5V814H214.4V480.1z\"><\/path>\n\t\t<\/svg>\n\t\t<span class=\"modern-title\">Click or drag a file to this area to upload.<\/span>\n\n\t\t\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-6391-field_90\"\n\t\tname=\"wpforms_6391_90\" required\t\tvalue=\"\">\n<\/div><div id=\"wpforms-6391-field_107-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"107\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_107\">Mon enfant a des besoins sp\u00e9cifiques (TDAH, autisme, troubles du comportement...)<\/label><ul id=\"wpforms-6391-field_107\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_107_1\" name=\"wpforms[fields][107][]\" value=\"Oui\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_107_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_107_2\" name=\"wpforms[fields][107][]\" value=\"Non\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_107_2\">Non<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_108-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"108\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_108\">Pr\u00e9cisez : <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-6391-field_108\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][108]\" required><\/div><div id=\"wpforms-6391-field_80-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"80\"><div class=\"wpforms-clear wpforms-pagebreak-right\"><button class=\"wpforms-page-button wpforms-page-prev\" data-action=\"prev\" data-page=\"2\" data-formid=\"6391\" disabled>Pr\u00e9c\u00e9dent<\/button><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"2\" data-formid=\"6391\" disabled>Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-3 last \" style=\"display:none;\"><div id=\"wpforms-6391-field_43-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"43\"><h3 id=\"wpforms-6391-field_43\" name=\"wpforms[fields][43]\">CHOIX DU LIEU D&#039;ACCUEIL<\/h3><div class=\"wpforms-field-description\">Carnaval 2026<\/div><\/div><div id=\"wpforms-6391-field_66-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"66\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_66\">Veuillez choisir vos dates par semaine  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_66\" class=\"wpforms-field-required\"><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_66_2\" name=\"wpforms[fields][66][]\" value=\"Du lundi 27 avril 2026 au jeudi 30 avril 2026\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_66_2\">Du lundi 27 avril 2026 au jeudi 30 avril 2026<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_66_3\" name=\"wpforms[fields][66][]\" value=\"Du lundi 4 mai 2026 au vendredi 8 mai 2026\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_66_3\">Du lundi 4 mai 2026 au vendredi 8 mai 2026<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_59-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-field wpforms-conditional-show wpforms-field-select-style-classic\" data-field-id=\"59\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_59\">Veuillez choisir la plaine de vacances ou le point d\u2019accueil d\u00e9sir\u00e9 (Maternelle) <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-6391-field_59\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][59]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>-- S\u00e9lectionner un choix --<\/option><option value=\"1120 - Plaine Crois\u00e9e des Chemins I - \u00c9cole maternelle \u00c0 la Crois\u00e9e des Chemins - Avenue des Croix de Guerre, 80 \u00e0 1120 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1120 - Plaine Crois\u00e9e des Chemins I - \u00c9cole maternelle \u00c0 la Crois\u00e9e des Chemins - Avenue des Croix de Guerre, 80 \u00e0 1120 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1120 - Plaine Pagodes I - \u00c9cole maternelle des Pagodes - Avenue de Versailles, 89 \u00e0 1120 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1120 - Plaine Pagodes I - \u00c9cole maternelle des Pagodes - Avenue de Versailles, 89 \u00e0 1120 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1020 - Plaine L\u00e9opold I - \u00c9cole maternelle L\u00e9opold 1er - Rue Laneau, 5 \u00e0 1020 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1020 - Plaine L\u00e9opold I - \u00c9cole maternelle L\u00e9opold 1er - Rue Laneau, 5 \u00e0 1020 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1000 - Plaine Emile Andr\u00e9 I - \u00c9cole fondamentale Emile Andr\u00e9 - Rue Haute, 107 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1000 - Plaine Emile Andr\u00e9 I - \u00c9cole fondamentale Emile Andr\u00e9 - Rue Haute, 107 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1000 - Plaine H\u00e9liport I - Ecole fondamentale de l&#039;H\u00e9liport - Rue Simons, 12 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1000 - Plaine H\u00e9liport I - Ecole fondamentale de l&#039;H\u00e9liport - Rue Simons, 12 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1000 - Plaine Eburons I - Ecole maternelle des Eburons - Rue des Eburons, 50 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1000 - Plaine Eburons I - Ecole maternelle des Eburons - Rue des Eburons, 50 \u00e0 1000 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><option value=\"1130 - Centre d&#039;accueil Haren vers Adolphe Max - Rue de la Paroisse, 34 - 1130 Bruxelles - Enfants de 3 \u00e0 6 ans\" >1130 - Centre d&#039;accueil Haren vers Adolphe Max - Rue de la Paroisse, 34 - 1130 Bruxelles - Enfants de 3 \u00e0 6 ans<\/option><\/select><\/div><div id=\"wpforms-6391-field_114-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-field wpforms-conditional-show wpforms-field-select-style-classic\" data-field-id=\"114\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_114\">Veuillez choisir la plaine de vacances ou le point d\u2019accueil d\u00e9sir\u00e9 (Primaire) *<\/label><select id=\"wpforms-6391-field_114\" class=\"wpforms-field-medium\" name=\"wpforms[fields][114]\"><option value=\"1120 - Plaine Crois\u00e9e des Chemins II - \u00c9cole primaire \u00c0 la Crois\u00e9e des Chemins - Avenue des Croix de Guerre, 78 \u00e0 1120 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1120 - Plaine Crois\u00e9e des Chemins II - \u00c9cole primaire \u00c0 la Crois\u00e9e des Chemins - Avenue des Croix de Guerre, 78 \u00e0 1120 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1120 - Plaine Pagodes II - \u00c9cole primaire Pagodes - Avenue des Pagodes, 305 \u00e0 1120 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1120 - Plaine Pagodes II - \u00c9cole primaire Pagodes - Avenue des Pagodes, 305 \u00e0 1120 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1020 - Plaine Steyls II - Ecole primaire Steyls - Rue Thys-Vanham, 21 \u00e0 1020 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1020 - Plaine Steyls II - Ecole primaire Steyls - Rue Thys-Vanham, 21 \u00e0 1020 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1000 - Plaine Robert Catteau II - Ecole primaire Robert Catteau - Rue des Minimes, 81 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1000 - Plaine Robert Catteau II - Ecole primaire Robert Catteau - Rue des Minimes, 81 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1000 - Plaine H\u00e9liport II - Ecole fondamentale de l&#039;H\u00e9liport  - Rue Simons, 12 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1000 - Plaine H\u00e9liport II - Ecole fondamentale de l&#039;H\u00e9liport  - Rue Simons, 12 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1000 - Plaine Eburons II - Ecole fondamentale des Eburons - Rue des Eburons, 46 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1000 - Plaine Eburons II - Ecole fondamentale des Eburons - Rue des Eburons, 46 \u00e0 1000 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><option value=\"1130 - Centre d&#039;accueil Haren vers Adolphe Max - Rue de la Paroisse, 34 - 1130 Bruxelles - Enfants de 6 \u00e0 12 ans\" >1130 - Centre d&#039;accueil Haren vers Adolphe Max - Rue de la Paroisse, 34 - 1130 Bruxelles - Enfants de 6 \u00e0 12 ans<\/option><\/select><\/div><div id=\"wpforms-6391-field_71-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"71\"><h3 id=\"wpforms-6391-field_71\" name=\"wpforms[fields][71]\">Horaire du Centre d&#039;accueil<\/h3><div class=\"wpforms-field-description\">Liaison au bus vers le lieu de plaine\nLe matin : de 7h \u00e0 8h\nLe soir : 17h \u00e0 18h\n\nPour une question d\u2019organisation et, surtout, de s\u00e9curit\u00e9, ces horaires doivent \u00eatre scrupuleusement respect\u00e9s. En cas de retard, l\u2019acc\u00e8s au centre d\u2019accueil vous sera refus\u00e9.\nDe m\u00eame, vous devez aller rechercher vos enfants \u00e0 l\u2019endroit o\u00f9 vous les avez d\u00e9pos\u00e9s le matin. Il n\u2019est pas possible de changer de Centre d\u2019accueil au cours de la journ\u00e9e.\n<\/div><\/div><div id=\"wpforms-6391-field_72-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"72\"><h3 id=\"wpforms-6391-field_72\" name=\"wpforms[fields][72]\">Horaire en plaine<\/h3><div class=\"wpforms-field-description\">Accueil directement sur le lieu de la plaine\nLe matin : de 7h00 \u00e0 8h45\nLe soir : 16h30 \u00e0 18h00\n\nPour une question d\u2019organisation et, surtout, de s\u00e9curit\u00e9, ces horaires doivent \u00eatre scrupuleusement respect\u00e9s. En cas de retard, l\u2019acc\u00e8s \u00e0 la plaine vous sera refus\u00e9.\nDe m\u00eame, vous devez aller rechercher vos enfants \u00e0 l\u2019endroit o\u00f9 vous les avez d\u00e9pos\u00e9s le matin. Il n\u2019est pas possible de changer de Centre d\u2019accueil au cours de la journ\u00e9e.\n<\/div><\/div><div id=\"wpforms-6391-field_62-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"62\"><label class=\"wpforms-field-label\" for=\"wpforms-6391-field_62\">Je confirme mes choix de date(s) et de lieu ? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-6391-field_62\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-6391-field_62_1\" name=\"wpforms[fields][62][]\" value=\"oui\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6391-field_62_1\">oui<\/label><\/li><\/ul><\/div><div id=\"wpforms-6391-field_76-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"76\"><div class=\"wpforms-clear wpforms-pagebreak-right\"><\/div><\/div><\/div><\/div><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-6391-field-hp\" class=\"wpforms-field-label\">Email<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-6391-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" style=\"display:none;\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"6391\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"5\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-6391\" class=\"wpforms-submit\" data-alt-text=\"Envoi en cours\" data-submit-text=\"Envoyer l&#039;inscription \u00e0 Jeunesse \u00e0 Bruxelles A.S.B.L.\" aria-live=\"assertive\" value=\"wpforms-submit\">Envoyer l&#039;inscription \u00e0 Jeunesse \u00e0 Bruxelles A.S.B.L.<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":5,"featured_media":0,"parent":65,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4732","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/pages\/4732","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/comments?post=4732"}],"version-history":[{"count":13,"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/pages\/4732\/revisions"}],"predecessor-version":[{"id":6395,"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/pages\/4732\/revisions\/6395"}],"up":[{"embeddable":true,"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/pages\/65"}],"wp:attachment":[{"href":"https:\/\/www.jeunesseabruxelles.be\/site\/wp-json\/wp\/v2\/media?parent=4732"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}