{"id":2956,"date":"2026-08-21T12:34:44","date_gmt":"2026-08-21T16:34:44","guid":{"rendered":"https:\/\/ha-mtl.org\/form\/paiement-pour-activites\/"},"modified":"2026-08-30T14:59:52","modified_gmt":"2026-08-30T18:59:52","slug":"paiement-pour-activites","status":"publish","type":"page","link":"https:\/\/ha-mtl.org\/fr\/form\/paiement-pour-activites\/","title":{"rendered":"Paiement pour activit\u00e9s"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_flex_section\">\n<div class=\"et_pb_row_0 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_0 et_pb_column et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_16_24 et_flex_column_16_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_image_0 et_pb_image et_pb_image_sticky_phone et_animated et_pb_module et_flex_module\"><span class=\"et_pb_image_wrap\"><img decoding=\"async\" src=\"https:\/\/ha-mtl.org\/wp-content\/uploads\/2026\/08\/form-activities-payment-main.jpg\" 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class=\"et_pb_promo_description\"><h1 class=\"et_pb_module_header\">Paiement des activit\u00e9s<\/h1><div class=\"et_pb_promo_content\"><p>Veuillez saisir les informations demand\u00e9es et effectuer votre paiement ci-dessous.<\/p>\n<\/div><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_1 et_pb_section et_section_regular et_flex_section\">\n<div class=\"et_pb_row_1 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_2 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_code_0 et_pb_code et_pb_module\"><div class=\"et_pb_code_inner\"><script>\nvar 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gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_20'  action='\/fr\/wp-json\/wp\/v2\/pages\/2956' data-formid='20' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_40' id='input_20_40' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Paiement pour activit\u00e9s' \/><\/div><\/div><fieldset id=\"field_20_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom du parent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_1'>\n                            \n                            <span id='input_20_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_20_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_1_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_20_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_20_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_1_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_20_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_3'><span class='gform-field-label__text'>Adresse courriel<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_20_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_20_4\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_4'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_20_4' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_20_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom de l\u2019\u00e9l\u00e8ve<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_5'>\n                            \n                            <span id='input_20_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_20_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_5_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_20_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_20_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_5_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_20_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_6'><span class='gform-field-label__text'>Niveau<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_20_6' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Veuillez choisir --<\/option><option value='Personnel' >Personnel<\/option><option value='1A' >1A<\/option><option value='1B' >1B<\/option><option value='2A' >2A<\/option><option value='2B' >2B<\/option><option value='3A' >3A<\/option><option value='3B' >3B<\/option><option value='4A' >4A<\/option><option value='4B' >4B<\/option><option value='5A' >5A<\/option><option value='5B' >5B<\/option><option value='6A' >6A<\/option><option value='6B' >6B<\/option><option value='7B' >7B<\/option><option value='7G' >7G<\/option><option value='8B' >8B<\/option><option value='8G' >8G<\/option><option value='9B' >9B<\/option><option value='9G' >9G<\/option><option value='10B' >10B<\/option><option value='10G' >10G<\/option><option value='11B' >11B<\/option><option value='11G' >11G<\/option><\/select><\/div><\/div><div id=\"field_20_7\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_7'><span class='gform-field-label__text'>Quel est l\u2019objet de votre paiement ? (PERSONNEL) <\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_20_7' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Veuillez choisir --<\/option><option value='staff_test_payment' >[x] Paiement de test<\/option><option value='staff_other' >AUTRE<\/option><\/select><\/div><\/div><div id=\"field_20_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_43'><span class='gform-field-label__text'>Indiquez l\u2019activit\u00e9 (PERSONNEL)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_20_43' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_44\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-half gfield_price gfield_price_20_44 gfield_product_20_44 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_44'><span class='gform-field-label__text'>Indiquez le montant<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_44' id='input_20_44' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_37\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_37 gfield_product_20_37 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_37_1'><span class='gform-field-label__text'>Paiement de test<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_37.1' value='Paiement de test' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_37' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_37' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_37.2' id='ginput_base_price_20_37' value='$ 1.00 CAD' aria-label='Paiement de test Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_37.3' value='1' class='ginput_quantity_20_37 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_42\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_42'><span class='gform-field-label__text'>Quel est l\u2019objet de votre paiement ? (PRIMAIRE) <\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_20_42' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Veuillez choisir --<\/option><option value='es_batmitzvah_first' >[x] Bat Mitzvah - premier versement<\/option><option value='es_batmitzvah_second' >[x] Bat Mitzvah - second versement (solde)<\/option><option value='es_basketball_boys' >Basketball gar\u00e7ons<\/option><option value='es_basketball_girls' >Basketball filles<\/option><option value='es_girls_dance' >[x] Cours de danse filles<\/option><option value='es_syium_grade6' >Siyoum de la 6e ann\u00e9e<\/option><option value='es_soccer_boys' >Soccer gar\u00e7ons<\/option><option value='es_soccer_girls' >Soccer filles<\/option><option value='es_other' >AUTRE<\/option><\/select><\/div><\/div><div id=\"field_20_9\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_9 gfield_product_20_9 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_9_1'><span class='gform-field-label__text'>Bat Mitzvah - premier versement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_9.1' value='Bat Mitzvah - premier versement' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_9' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_9' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_9.2' id='ginput_base_price_20_9' value='$ 850.00 CAD' aria-label='Bat Mitzvah - premier versement Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_9.3' value='1' class='ginput_quantity_20_9 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_10\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_10 gfield_product_20_10 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_10'><span class='gform-field-label__text'>Bat Mitzvah - second versement (solde)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_10' id='input_20_10' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_11\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_11 gfield_product_20_11 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_11'><span class='gform-field-label__text'>Basketball gar\u00e7ons<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_11' id='input_20_11' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_12\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_12 gfield_product_20_12 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_12_1'><span class='gform-field-label__text'>Basketball filles<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_12.1' value='Basketball filles' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_12' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_12' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_12.2' id='ginput_base_price_20_12' value='$ 250.00 CAD' aria-label='Basketball filles Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_12.3' value='1' class='ginput_quantity_20_12 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_24\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_24 gfield_product_20_24 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_24_1'><span class='gform-field-label__text'>Cours de danse filles<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_24.1' value='Cours de danse filles' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_24' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_24' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_24.2' id='ginput_base_price_20_24' value='$ 25.00 CAD' aria-label='Cours de danse filles Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_24.3' value='1' class='ginput_quantity_20_24 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_13\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_13 gfield_product_20_13 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_13_1'><span class='gform-field-label__text'>Siyoum de la 6e ann\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_13.1' value='Siyoum de la 6e ann\u00e9e' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_13' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_13' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_13.2' id='ginput_base_price_20_13' value='$ 100.00 CAD' aria-label='Siyoum de la 6e ann\u00e9e Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_13.3' value='1' class='ginput_quantity_20_13 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_14\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_14 gfield_product_20_14 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_14_1'><span class='gform-field-label__text'>Soccer gar\u00e7ons<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_14.1' value='Soccer gar\u00e7ons' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_14' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_14' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_14.2' id='ginput_base_price_20_14' value='$ 200.00 CAD' aria-label='Soccer gar\u00e7ons Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_14.3' value='1' class='ginput_quantity_20_14 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_15\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_15 gfield_product_20_15 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_15_1'><span class='gform-field-label__text'>Soccer filles<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_15.1' value='Soccer filles' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_15' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_15' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_15.2' id='ginput_base_price_20_15' value='$ 200.00 CAD' aria-label='Soccer filles Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_15.3' value='1' class='ginput_quantity_20_15 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_18'><span class='gform-field-label__text'>Indiquez l\u2019activit\u00e9 (PRIMAIRE)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_20_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_17\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-half gfield_price gfield_price_20_17 gfield_product_20_17 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_17'><span class='gform-field-label__text'>Indiquez le montant<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_17' id='input_20_17' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_8\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_8'><span class='gform-field-label__text'>Quel est l\u2019objet de votre paiement ? (SECONDAIRE) <\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_20_8' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-- Veuillez choisir --<\/option><option value='hs_achdut_trip' >[x] Voyage d\u2019Achdout<\/option><option value='hs_basketball_gmaa' >Basketball GMAA<\/option><option value='hs_flag_football' >Flag football<\/option><option value='hs_futsal' >Futsal<\/option><option value='hs_voleyball_girls' >Volleyball filles<\/option><option value='hs_golf' >[x] Golf<\/option><option value='hs_halo_race' >Course Halo<\/option><option value='hs_tennis' >Tennis<\/option><option value='hs_basketball_memphis' >[x] Tournoi de basketball masculin juv\u00e9nile de Memphis<\/option><option value='hs_mishmar_sponsorship' >Parrainage du Mishmar<\/option><option value='hs_ogt_fee' >[x] Frais de participation joueur OGT<\/option><option value='hs_outdoor_soccer' >Soccer ext\u00e9rieur<\/option><option value='hs_shabbaton' >[x] Shabbaton<\/option><option value='hs_shabbaton_gr78' >[x] Shabbaton 7e-8e ann\u00e9e<\/option><option value='hs_washington_trip' >Voyage \u00e0 Washington<\/option><option value='hs_la_basketball_tournament_deposit' >Tournoi de basket-ball de LA \u2013 acompte<\/option><option value='hs_other' >AUTRE<\/option><\/select><\/div><\/div><div id=\"field_20_20\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_20 gfield_product_20_20 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_20_1'><span class='gform-field-label__text'>Voyage d\u2019Achdout<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_20.1' value='Voyage d\u2019Achdout' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_20' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_20' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_20.2' id='ginput_base_price_20_20' value='$ 15.00 CAD' aria-label='Voyage d\u2019Achdout Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_20.3' value='1' class='ginput_quantity_20_20 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_21\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_21 gfield_product_20_21 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_21_1'><span class='gform-field-label__text'>Basketball GMAA<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_21.1' value='Basketball GMAA' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_21' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_21' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_21.2' id='ginput_base_price_20_21' value='$ 275.00 CAD' aria-label='Basketball GMAA Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_21.3' value='1' class='ginput_quantity_20_21 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_22\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_22 gfield_product_20_22 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_22_1'><span class='gform-field-label__text'>Flag football<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_22.1' value='Flag football' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_22' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_22' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_22.2' id='ginput_base_price_20_22' value='$ 95.00 CAD' aria-label='Flag football Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_22.3' value='1' class='ginput_quantity_20_22 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_50\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_50 gfield_product_20_50 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_50_1'><span class='gform-field-label__text'>Futsal<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_50.1' value='Futsal' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_50' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_50' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_50.2' id='ginput_base_price_20_50' value='$ 95.00 CAD' aria-label='Futsal Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_50.3' value='1' class='ginput_quantity_20_50 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_25\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_25 gfield_product_20_25 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_25_1'><span class='gform-field-label__text'>Volleyball filles<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_25.1' value='Volleyball filles' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_25' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_25' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_25.2' id='ginput_base_price_20_25' value='$ 80.00 CAD' aria-label='Volleyball filles Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_25.3' value='1' class='ginput_quantity_20_25 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_26\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_26 gfield_product_20_26 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_26_1'><span class='gform-field-label__text'>Golf<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_26.1' value='Golf' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_26' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_26' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_26.2' id='ginput_base_price_20_26' value='$ 50.00 CAD' aria-label='Golf Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_26.3' value='1' class='ginput_quantity_20_26 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_27\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_27 gfield_product_20_27 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_27_1'><span class='gform-field-label__text'>Course Halo<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_27.1' value='Course Halo' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_27' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_27' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_27.2' id='ginput_base_price_20_27' value='$ 50.00 CAD' aria-label='Course Halo Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_27.3' value='1' class='ginput_quantity_20_27 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_51\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_51 gfield_product_20_51 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_51_1'><span class='gform-field-label__text'>Tennis<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_51.1' value='Tennis' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_51' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_51' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_51.2' id='ginput_base_price_20_51' value='$ 95.00 CAD' aria-label='Tennis Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_51.3' value='1' class='ginput_quantity_20_51 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_29\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_29 gfield_product_20_29 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_29'><span class='gform-field-label__text'>Tournoi de basketball masculin juv\u00e9nile de Memphis<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_29' id='input_20_29' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_30\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_30 gfield_product_20_30 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_30_1'><span class='gform-field-label__text'>Parrainage du Mishmar<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_30.1' value='Parrainage du Mishmar' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_30' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_30' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_30.2' id='ginput_base_price_20_30' value='$ 360.00 CAD' aria-label='Parrainage du Mishmar Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_30.3' value='1' class='ginput_quantity_20_30 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_28\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_28 gfield_product_20_28 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_28_1'><span class='gform-field-label__text'>Frais de participation joueur OGT<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_28.1' value='Frais de participation joueur OGT' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_28' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_28' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_28.2' id='ginput_base_price_20_28' value='$ 360.00 CAD' aria-label='Frais de participation joueur OGT Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_28.3' value='1' class='ginput_quantity_20_28 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_52\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_52 gfield_product_20_52 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_52_1'><span class='gform-field-label__text'>Tournoi de basket-ball de LA \u2013 acompte<\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_52.1' value='Tournoi de basket-ball de LA \u2013 acompte' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_52' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_52' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_52.2' id='ginput_base_price_20_52' value='$ 500.00 CAD' aria-label='Tournoi de basket-ball de LA \u2013 acompte Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_52.3' value='1' class='ginput_quantity_20_52 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_32\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_32 gfield_product_20_32 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_32_1'><span class='gform-field-label__text'>Soccer ext\u00e9rieur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_32.1' value='Soccer ext\u00e9rieur' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_32' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_32' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_32.2' id='ginput_base_price_20_32' value='$ 80.00 CAD' aria-label='Soccer ext\u00e9rieur Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_32.3' value='1' class='ginput_quantity_20_32 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_33\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_33 gfield_product_20_33 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_33'><span class='gform-field-label__text'>Shabbaton<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_33' id='input_20_33' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_45\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_20_45 gfield_product_20_45 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_45_1'><span class='gform-field-label__text'>Shabbaton 7e-8e ann\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_45.1' value='Shabbaton 7e-8e ann\u00e9e' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_45' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_45' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Prix:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_45.2' id='ginput_base_price_20_45' value='$ 60.00 CAD' aria-label='Shabbaton 7e-8e ann\u00e9e Prix'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_45.3' value='1' class='ginput_quantity_20_45 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_34\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_34 gfield_product_20_34 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_34'><span class='gform-field-label__text'>Voyage \u00e0 Washington<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_34' id='input_20_34' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_35'><span class='gform-field-label__text'>Indiquez l\u2019activit\u00e9 (SECONDAIRE)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_20_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_36\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-half gfield_price gfield_price_20_36 gfield_product_20_36 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_36'><span class='gform-field-label__text'>Indiquez le montant<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_36' id='input_20_36' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_46'><span class='gform-field-label__text'>Exigences alimentaires<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_20_46' type='text' value='' class='large'  aria-describedby=\"gfield_description_20_46\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_20_46'>Ex. : allergie, intol\u00e9rance, v\u00e9g\u00e9tarisme, etc.<\/div><\/div><fieldset id=\"field_20_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Viendrez-vous chercher votre enfant ?<\/span><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_20_47'>\n\t\t\t<div class='gchoice gchoice_20_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='Oui'  id='choice_20_47_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_47_0' id='label_20_47_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_20_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='Non'  id='choice_20_47_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_47_1' id='label_20_47_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_20_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third 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type='radio' value='Non'  id='choice_20_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_48_1' id='label_20_48_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_20_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_49'><span class='gform-field-label__text'>\u00c0 quelle adresse doit-il \u00eatre accompagn\u00e9 ?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_20_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div 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