{"id":988119,"date":"2023-05-23T19:27:27","date_gmt":"2023-05-23T18:27:27","guid":{"rendered":"http:\/\/teddysplayschool.com\/?page_id=988119"},"modified":"2023-05-25T18:13:01","modified_gmt":"2023-05-25T17:13:01","slug":"formulaire","status":"publish","type":"page","link":"https:\/\/teddysplayschool.com\/index.php\/formulaire\/","title":{"rendered":"formulaire d&rsquo;inscription en ligne"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"988119\" class=\"elementor elementor-988119\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-aed1dbb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"aed1dbb\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5a2ea4f\" data-id=\"5a2ea4f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-665c075 elementor-widget elementor-widget-html\" data-id=\"665c075\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_1' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">INSCRIPTION<\/h2>\n                            <span class='gform_description'><\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/index.php\/wp-json\/wp\/v2\/pages\/988119' novalidate>\n                        <div class='gform_body gform-body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_1_73\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_73\"><img decoding=\"async\" src=\"http:\/\/teddysplayschool.com\/wp-content\/uploads\/2022\/12\/1526515180971_LOGOTEDDYSPLAYSCHOOL.png\"><\/div><div id=\"field_1_11\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_11\"><h2><center>FICHE DE RENSEIGNEMENT<br> \n             TEDDY\u2019S PLAYSCHOOL <\/center><\/h2><\/div><fieldset id=\"field_1_14\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_14\"><legend class='gfield_label'  >INSCRIPTION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_14'>\n\t\t\t<div class='gchoice gchoice_1_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Cr\u00e8che'  id='choice_1_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_0' id='label_1_14_0'>Cr\u00e8che<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Toute Petite Section'  id='choice_1_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_1' id='label_1_14_1'>Toute Petite Section<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Petite Section'  id='choice_1_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_2' id='label_1_14_2'>Petite Section<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Moyenne Section'  id='choice_1_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_3' id='label_1_14_3'>Moyenne Section<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Grande Section'  id='choice_1_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_4' id='label_1_14_4'>Grande Section<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_75\"  class=\"gfield gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_75\"><h4>PIECES A FOURNIR<\/h4>\n<h5>Un Extrait de Naissance (moins de 3 mois) <\/h5>\n<h5>2 Photos d'identit\u00e9<\/h5>\n<h5>Photocopie Livret de famille<\/h5>\n<h5>Photocopie Carnet de vaccination<\/h5><\/div><fieldset id=\"field_1_15\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_15\"><legend class='gfield_label'  >CANTINE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_15'>\n\t\t\t<div class='gchoice gchoice_1_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Oui'  id='choice_1_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_15_0' id='label_1_15_0'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Non'  id='choice_1_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_15_1' id='label_1_15_1'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_16\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_16\"><legend class='gfield_label gfield_label_before_complex'  >ELEVE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_16'>\n                            \n                            <span id='input_1_16_3_container' class='name_first' >\n                                                    <input type='text' name='input_16.3' id='input_1_16_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_16_3' >Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_16_6_container' class='name_last' >\n                                                    <input type='text' name='input_16.6' id='input_1_16_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_16_6' >Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_17\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_17\"><legend class='gfield_label gfield_label_before_complex'  >Date de Naissance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_1_17' class='ginput_container ginput_complex'>\n                                        <div class='gfield_date_day ginput_container ginput_container_date' id='input_1_17_2_container'>\n                                            <input type='number'  name='input_17[]' id='input_1_17_2' value=''   aria-required='true'   placeholder='JJ' min='1' max='31' step='1'\/>\n                                            <label for='input_1_17_2' class='screen-reader-text'>Jour<\/label>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date' id='input_1_17_1_container'>\n                                        <input type='number'  name='input_17[]' id='input_1_17_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_1_17_1' class='screen-reader-text'>Mois<\/label>\n                                   <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_1_17_3_container'>\n                                        <input type='number'  name='input_17[]' id='input_1_17_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2025' step='1'\/>\n                                        <label for='input_1_17_3' class='screen-reader-text'>Ann\u00e9e<\/label>\n                                   <\/div>\n                                <\/div><\/fieldset><fieldset id=\"field_1_18\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_18\"><legend class='gfield_label gfield_label_before_complex'  >Lieu de Naissance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street ginput_container_address' id='input_1_18' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_18_1_container' >\n                                        <input type='text' name='input_18.1' id='input_1_18_1' value=''    aria-required='true'    \/>\n                                        <label for='input_1_18_1' id='input_1_18_1_label' class='hidden_sub_label screen-reader-text'>Adresse postale<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_18.4' id='input_1_18_4' value=''\/><input type='hidden' class='gform_hidden' name='input_18.6' id='input_1_18_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 7;\"><\/div><fieldset id=\"field_1_20\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_20\"><legend class='gfield_label'  >SEXE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_20'>\n\t\t\t<div class='gchoice gchoice_1_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='M'  id='choice_1_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_0' id='label_1_20_0'>M<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='F'  id='choice_1_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_1' id='label_1_20_1'>F<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_21\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_21\"><legend class='gfield_label gfield_label_before_complex'  >Nationalit\u00e9<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_country ginput_container_address' id='input_1_21' >\n                        <input type='hidden' class='gform_hidden' name='input_21.4' id='input_1_21_4' value=''\/><span class='ginput_left address_country ginput_address_country' id='input_1_21_6_container' >\n                                        <select name='input_21.6' id='input_1_21_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba ' >Bonaire, Saint-Eustache et Saba <\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo, Republic of the' >Congo, Republic of the<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Czech Republic' >Czech Republic<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Heard and McDonald Islands' >Heard and McDonald Islands<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macau' >Macau<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='North Korea' >North Korea<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Russia' >Russia<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena' >Saint Helena<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='South Georgia' >South Georgia<\/option><option value='South Korea' >South Korea<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands<\/option><option value='Syria' >Syria<\/option><option value='S\u00e9n\u00e9gal' selected='selected'>S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzania' >Tanzania<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkey' >Turkey<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_1_21_6' id='input_1_21_6_label' >Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_1_23\"  class=\"gfield gfield--width-eleven-twelfths gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_23\"><label class='gfield_label' for='input_1_23' >Votre enfant a-t-il d\u00e9j\u00e0 v\u00e9cu en collectivit\u00e9 ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_1_23' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_24\"  class=\"gfield gfield--width-eleven-twelfths gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_24\"><label class='gfield_label' for='input_1_24' >Dans quel \u00e9tablissement (cr\u00e8che, garderie, \u00e9cole, etc.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_1_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_25\"  class=\"gfield gfield--width-five-twelfths gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_25\"><label class='gfield_label' for='input_1_25' >Langue maternelle<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_1_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_26\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_26\"><label class='gfield_label' for='input_1_26' >Autre(s) langue(s) parl\u00e9e(s)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_1_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_27\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_27\"><h3>PARENT OU PERSONNES RESPONSABLES <\/h3><\/div><div id=\"field_1_28\"  class=\"gfield gfield--width-eleven-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_28\"><label class='gfield_label' for='input_1_28' >Nom et pr\u00e9noms du p\u00e8re<\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_1_28' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_30\"  class=\"gfield gfield--width-eleven-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_30\"><label class='gfield_label' for='input_1_30' >Nom de jeune fille de la m\u00e8re et pr\u00e9noms<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_1_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_29\"  class=\"gfield gfield--width-five-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_29\"><label class='gfield_label' for='input_1_29' >Adresse des parents<\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_1_29' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_31\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_31\"><label class='gfield_label' for='input_1_31' >Num\u00e9ro de t\u00e9l\u00e9phone fixe<\/label><div class='ginput_container ginput_container_phone'><input name='input_31' id='input_1_31' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 1;\"><\/div><div id=\"field_1_68\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_68\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_1_32\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_32\"><label class='gfield_label' for='input_1_32' >Portable p\u00e8re<\/label><div class='ginput_container ginput_container_phone'><input name='input_32' id='input_1_32' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_33\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_33\"><label class='gfield_label' for='input_1_33' >Portable de la m\u00e8re<\/label><div class='ginput_container ginput_container_phone'><input name='input_33' id='input_1_33' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_34\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_34\"><label class='gfield_label' for='input_1_34' >E-mail<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_34' id='input_1_34' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_1_35\"  class=\"gfield gfield--width-five-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_35\"><label class='gfield_label' for='input_1_35' >Profession du p\u00e8re<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_1_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_36\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_36\"><label class='gfield_label' for='input_1_36' >Nom de l\u2019employeur<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_1_36' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_38\"  class=\"gfield gfield--width-quarter field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_38\"><label class='gfield_label' for='input_1_38' >T\u00e9l\u00e9phone de l\u2019employeur<\/label><div class='ginput_container ginput_container_phone'><input name='input_38' id='input_1_38' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_72\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_72\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_1_39\"  class=\"gfield gfield--width-five-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_39\"><label class='gfield_label' for='input_1_39' >Profession de la m\u00e8re<\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_1_39' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_40\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_40\"><label class='gfield_label' for='input_1_40' >Nom de l\u2019employeur<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_1_40' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_41\"  class=\"gfield gfield--width-quarter field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_41\"><label class='gfield_label' for='input_1_41' >T\u00e9l\u00e9phone de l\u2019employeur<\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_1_41' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_42\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_42\"><label class='gfield_label' for='input_1_42' >Rang de l\u2019enfant dans la famille<\/label><div class='ginput_container ginput_container_number'><input name='input_42' id='input_1_42' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_1_43\"  class=\"gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_43\"><label class='gfield_label' for='input_1_43' >sur<\/label><div class='ginput_container ginput_container_number'><input name='input_43' id='input_1_43' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 4;\"><\/div><div id=\"field_1_44\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_44\"><label class='gfield_label' for='input_1_44' >Nom et t\u00e9l\u00e9phone du m\u00e9decin traitant<\/label><div class='ginput_container ginput_container_phone'><input name='input_44' id='input_1_44' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_1_45\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_45\"><h3>OBSERVATIONS DES PARENTS (scolarit\u00e9, sant\u00e9) <\/h3><\/div><div id=\"field_1_46\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_46\"><label class='gfield_label' for='input_1_46' >Observations<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_46' id='input_1_46' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_1_47\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_47\"><h3>Personne a pr\u00e9venir en cas de n\u00e9cessite (si les parents ne sont pas joignables) <\/h3><\/div><fieldset id=\"field_1_48\"  class=\"gfield gfield--width-seven-twelfths gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_1_48\"><legend class='gfield_label gfield_label_before_complex'  >Nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_48'>\n                            \n                            <span id='input_1_48_3_container' class='name_first' >\n                                                    <input type='text' name='input_48.3' id='input_1_48_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_48_3' >Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_48_6_container' class='name_last' >\n                                                    <input type='text' name='input_48.6' id='input_1_48_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_48_6' >Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_1_49\"  class=\"gfield gfield--width-five-twelfths field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_49\"><label class='gfield_label' for='input_1_49' >T\u00e9l\u00e9phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_49' id='input_1_49' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_58\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_58\"><h3>Personnes autoris\u00e9es \u00e0 prendre l\u2019enfant en cas d\u2019emp\u00eachement des parents<\/h3><\/div><fieldset id=\"field_1_52\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_52\"><legend class='gfield_label gfield_label_before_complex'  >Nom<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_52'>\n                            \n                            <span id='input_1_52_3_container' class='name_first' >\n                                                    <input type='text' name='input_52.3' id='input_1_52_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_1_52_3' >Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_52_6_container' class='name_last' >\n                                                    <input type='text' name='input_52.6' id='input_1_52_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_1_52_6' >Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_1_53\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_53\"><label class='gfield_label' for='input_1_53' >T\u00e9l\u00e9phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_53' id='input_1_53' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_1_54\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_54\"><legend class='gfield_label gfield_label_before_complex'  >Nom<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_54'>\n                            \n                            <span id='input_1_54_3_container' class='name_first' >\n                                                    <input type='text' name='input_54.3' id='input_1_54_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_1_54_3' >Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_54_6_container' class='name_last' >\n                                                    <input type='text' name='input_54.6' id='input_1_54_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_1_54_6' >Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_1_55\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_55\"><label class='gfield_label' for='input_1_55' >T\u00e9l\u00e9phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_55' id='input_1_55' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_62\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_62\"><h3>AUTORISATIONS DIVERSES DE LA STRUCTURE<\/h3><\/div><fieldset id=\"field_1_63\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_63\"><legend class='gfield_label'  >A appeler un service d\u2019urgence priv\u00e9 en cas d\u2019accident ou de sympt\u00f4mes graves demandant une intervention rapide.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_63'>\n\t\t\t<div class='gchoice gchoice_1_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Oui'  id='choice_1_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_63_0' id='label_1_63_0'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Non'  id='choice_1_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_63_1' id='label_1_63_1'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_64\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_64\"><legend class='gfield_label'  >A photographier et a filmer mon enfant a des fins p\u00e9dagogiques ou m\u00e9dicales (journal \u00e9cole, site publication, reportage)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_64'>\n\t\t\t<div class='gchoice gchoice_1_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='Oui'  id='choice_1_64_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_64_0' id='label_1_64_0'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='Non'  id='choice_1_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_64_1' id='label_1_64_1'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_65\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_65\"><h4>Si une modification intervenait en cours d\u2019ann\u00e9e, veuillez informer par \u00e9crit\nl\u2019enseignant ou la directrice de l\u2019\u00e9cole<\/h4><\/div><div id=\"field_1_66\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_66\"><h4>J\u2019AI PRIS CONNAISSANCE DU R\u00c8GLEMENT INT\u00c9RIEUR DE TEDDY\u2019S\nPLAYSCHOOL<\/h4><\/div><fieldset id=\"field_1_67\"  class=\"gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_67\"><legend class='gfield_label gfield_label_before_complex'  >Fait \u00e0 Dakar le<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_1_67' class='ginput_container ginput_complex'>\n                                        <div class='gfield_date_day ginput_container ginput_container_date' id='input_1_67_2_container'>\n                                            <input type='number'  name='input_67[]' id='input_1_67_2' value=''   aria-required='true'   placeholder='JJ' min='1' max='31' step='1'\/>\n                                            <label for='input_1_67_2' class='screen-reader-text'>Jour<\/label>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date' id='input_1_67_1_container'>\n                                        <input type='number'  name='input_67[]' id='input_1_67_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_1_67_1' class='screen-reader-text'>Mois<\/label>\n                                   <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_1_67_3_container'>\n                                        <input type='number'  name='input_67[]' id='input_1_67_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2025' step='1'\/>\n                                        <label for='input_1_67_3' class='screen-reader-text'>Ann\u00e9e<\/label>\n                                   <\/div>\n                                <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 8;\"><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='Envoyer'  onclick='if(window[\"gf_submitting_1\"]){return false;}  if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_1\"]){return false;} if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  jQuery(\"#gform_1\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-0655ef0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0655ef0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-6b07558\" data-id=\"6b07558\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","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":""},"_links":{"self":[{"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/pages\/988119"}],"collection":[{"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/comments?post=988119"}],"version-history":[{"count":31,"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/pages\/988119\/revisions"}],"predecessor-version":[{"id":988387,"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/pages\/988119\/revisions\/988387"}],"wp:attachment":[{"href":"https:\/\/teddysplayschool.com\/index.php\/wp-json\/wp\/v2\/media?parent=988119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}