<div class='fluentform fluentform_wrapper_14'><form data-form_id="14" id="fluentform_14" class="frm-fluent-form fluent_form_14 ff-el-form-top ff_form_instance_14_1 ff-form-loading" data-form_instance="ff_form_instance_14_1" method="POST" ><input type='hidden' name='__fluent_form_embded_post_id' value='7594' /><input type="hidden" id="_fluentform_14_fluentformnonce" name="_fluentform_14_fluentformnonce" value="73c8263f82" /><input type="hidden" name="_wp_http_referer" value="/inscription-aux-ateliers-et-a-lassemblee-generale-2023/" /><div data-type="name-element" data-name="names" class=" ff-field_container ff-name-field-wrapper" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_14_names_first_name_'>Prénom</label> </div><div class='ff-el-input--content'><input type="text" name="names[first_name]" id="ff_14_names_first_name_" class="ff-el-form-control" placeholder="Votre Prénom" ></div></div></div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_14_names_last_name_'>Nom</label> </div><div class='ff-el-input--content'><input type="text" name="names[last_name]" id="ff_14_names_last_name_" class="ff-el-form-control" placeholder="Votre Nom" ></div></div></div></div></div><div class='ff-el-group'><div class='ff-el-input--label asterisk-right'><label for='ff_14_input_text'>Organisme</label> </div><div class='ff-el-input--content'><input type="text" name="input_text" class="ff-el-form-control" placeholder="Votre structure" data-name="input_text" id="ff_14_input_text" ></div></div><div class='ff-el-group'><div class='ff-el-input--label asterisk-right'><label for='ff_14_input_text_1'>Fonction</label> </div><div class='ff-el-input--content'><input type="text" name="input_text_1" class="ff-el-form-control" placeholder="Votre fonction" data-name="input_text_1" id="ff_14_input_text_1" ></div></div><div class='ff-el-group'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_14_email'>E-mail</label> </div><div class='ff-el-input--content'><input type="email" name="email" id="ff_14_email" class="ff-el-form-control" placeholder="Votre e-mail" data-name="email" ></div></div><div class='ff-el-group'><div class='ff-el-input--label asterisk-right'><label for='ff_14_phone'>Téléphone</label> </div><div class='ff-el-input--content'><input name="phone" class="ff-el-form-control ff-el-phone ff_el_with_extended_validation" type="tel" placeholder="Votre téléphone" data-name="phone" id="ff_14_phone" inputmode="tel" ></div></div><div class='ff-el-group ff-el-form-top'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label >Participerez-vous à la visite de site du 29 novembre (9h15 - 12h15) ? Circuit à pied d’environ 5 km</label> </div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_1_add39ed0fb234ee8938ae085828b1bbf><input type="radio" name="input_radio_1" data-name="input_radio_1" class="ff-el-form-check-input ff-el-form-check-radio" value="Oui" id='input_radio_1_add39ed0fb234ee8938ae085828b1bbf'> <span>Oui</span></label></div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_1_4493e996f88a7c1d644ac87498aeec4e><input type="radio" name="input_radio_1" data-name="input_radio_1" class="ff-el-form-check-input ff-el-form-check-radio" value="Non" id='input_radio_1_4493e996f88a7c1d644ac87498aeec4e'> <span>Non</span></label></div></div></div><div class='ff-el-group'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label >Resterez-vous déjeuner ? (12h15-13h45) Repas offert </label> </div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_c2e6084a6b549a60b89ebb6ce09ab7ef><input type="radio" name="input_radio" data-name="input_radio" class="ff-el-form-check-input ff-el-form-check-radio" value="Oui" id='input_radio_c2e6084a6b549a60b89ebb6ce09ab7ef'> <span>Oui</span></label></div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_c83c6d0b2729f3ccd0300f326e36d02b><input type="radio" name="input_radio" data-name="input_radio" class="ff-el-form-check-input ff-el-form-check-radio" value="Non" id='input_radio_c83c6d0b2729f3ccd0300f326e36d02b'> <span>Non</span></label></div></div></div><div class='ff-el-group'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label >Assisterez-vous aux ateliers (14h-16h30) ? </label> </div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_3_cae340f0de1894765f8be9492b960198><input type="radio" name="input_radio_3" data-name="input_radio_3" class="ff-el-form-check-input ff-el-form-check-radio" value="Oui" id='input_radio_3_cae340f0de1894765f8be9492b960198'> <span>Oui</span></label></div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_3_be90aa22463b3ebb19402c7bb36e40e4><input type="radio" name="input_radio_3" data-name="input_radio_3" class="ff-el-form-check-input ff-el-form-check-radio" value="Non" id='input_radio_3_be90aa22463b3ebb19402c7bb36e40e4'> <span>Non</span></label></div></div></div><div class='ff-el-group'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label >Assisterez-vous à l’assemblée générale (17h-18h30) ? Réservée aux membres </label> </div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_4_c2e4d86cd7e4671d74de553b98398eff><input type="radio" name="input_radio_4" data-name="input_radio_4" class="ff-el-form-check-input ff-el-form-check-radio" value="Oui" id='input_radio_4_c2e4d86cd7e4671d74de553b98398eff'> <span>Oui</span></label></div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_4_c895c8e0ed8849f5fb3000ed6c2f87f4><input type="radio" name="input_radio_4" data-name="input_radio_4" class="ff-el-form-check-input ff-el-form-check-radio" value="Non" id='input_radio_4_c895c8e0ed8849f5fb3000ed6c2f87f4'> <span>Non</span></label></div></div></div><div class='ff-el-group'><div class='ff-el-input--label asterisk-right'><label for='ff_14_description'>Commentaire</label> </div><div class='ff-el-input--content'><textarea name="description" id="ff_14_description" class="ff-el-form-control" rows="3" cols="2" data-name="description" ></textarea></div></div><div class='ff-el-group' data-name="recaptcha" ><div class='ff-el-input--content'><div data-fluent_id='14' name='g-recaptcha-response'><div
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