{"id":10814,"date":"2025-06-28T11:05:31","date_gmt":"2025-06-28T09:05:31","guid":{"rendered":"https:\/\/activitesbruxelles.be\/?page_id=10814"},"modified":"2025-09-09T22:44:46","modified_gmt":"2025-09-09T20:44:46","slug":"become-a-partner","status":"publish","type":"page","link":"https:\/\/activitesbruxelles.be\/en\/devenir-partenaire\/","title":{"rendered":"Become a partner"},"content":{"rendered":"<section class=\"bde-section-10814-100 bde-section\">\n              \n  \n  \n\t\n\n\n\n        <div class=\"section-shape-divider-wrapper section-shape-divider-wrapper--1\">\n          <span class=\"section-shape-divider\">\n                      <svg\n                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                viewBox=\"0 0 1440 320\"\n                preserveAspectRatio=\"none\"\n            >\n              <path d=\"M1440 0c-184.332-.001-361.303 50.904-491.646 141.42l-126.53 87.87c-56.236 39.052-147.412 39.052-203.648 0l-126.53-87.87C361.303 50.904 184.332-.001 0 0v320h1440V0Z\" fill=\"currentColor\"\/>\n            <\/svg>\n                    <\/span>\n      <\/div>\n  <div class=\"section-container\"><div class=\"bde-div-10814-104 bde-div\" data-entrance=\"slideUp\">\n  \n  \n\t\n\n\n\n<div class=\"bde-div-10814-101 bde-div\" data-entrance=\"slideUp\">\n  \n  \n\t\n\n\n\n<div class=\"bde-pulse-dot-10814-102 bde-pulse-dot\"><div class=\"bde-pulse-dot__ping\"><\/div>\r\n<div class=\"bde-pulse-dot__core\"><\/div><\/div><div class=\"bde-text-10814-103 bde-text\">\nDevenir partenaire\n<\/div>\n<\/div><h1 class=\"bde-heading-10814-105 bde-heading\" data-entrance=\"slideUp\">\nRejoignez notre r\u00e9seau de partenaires<br>\n<\/h1><p class=\"bde-text-10814-115 bde-text\" data-entrance=\"slideUp\">\nVous proposez des activit\u00e9s de qualit\u00e9 ? Rejoignez nos 30+ partenaires et boostez votre visibilit\u00e9 ! Remplissez ce formulaire en 5 minutes, notre \u00e9quipe partenariats vous recontacte sous 48h pour \u00e9tudier les opportunit\u00e9s de collaboration.\n<\/p><div class=\"bde-icon-list-10814-119 bde-icon-list\" data-entrance=\"fade\">\n<ul>\n  \n              \n    <li>\n              <div class='bde-icon-list__item-wrapper'>\n      \n      <span class='bde-icon-list__icon' aria-hidden='true'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.5.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M64 64c0-17.7-14.3-32-32-32S0 46.3 0 64V400c0 44.2 35.8 80 80 80H480c17.7 0 32-14.3 32-32s-14.3-32-32-32H80c-8.8 0-16-7.2-16-16V64zm406.6 86.6c12.5-12.5 12.5-32.8 0-45.3s-32.8-12.5-45.3 0L320 210.7l-57.4-57.4c-12.5-12.5-32.8-12.5-45.3 0l-112 112c-12.5 12.5-12.5 32.8 0 45.3s32.8 12.5 45.3 0L240 221.3l57.4 57.4c12.5 12.5 32.8 12.5 45.3 0l128-128z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      D\u00e9veloppez votre client\u00e8le\n      <\/span>\n              <\/div>\n      \n    <\/li>\n\n  \n              \n    <li>\n              <div class='bde-icon-list__item-wrapper'>\n      \n      <span class='bde-icon-list__icon' aria-hidden='true'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.5.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M272.2 64.6l-51.1 51.1c-15.3 4.2-29.5 11.9-41.5 22.5L153 161.9C142.8 171 129.5 176 115.8 176H96V304c20.4 .6 39.8 8.9 54.3 23.4l35.6 35.6 7 7 0 0L219.9 397c6.2 6.2 16.4 6.2 22.6 0c1.7-1.7 3-3.7 3.7-5.8c2.8-7.7 9.3-13.5 17.3-15.3s16.4 .6 22.2 6.5L296.5 393c11.6 11.6 30.4 11.6 41.9 0c5.4-5.4 8.3-12.3 8.6-19.4c.4-8.8 5.6-16.6 13.6-20.4s17.3-3 24.4 2.1c9.4 6.7 22.5 5.8 30.9-2.6c9.4-9.4 9.4-24.6 0-33.9L340.1 243l-35.8 33c-27.3 25.2-69.2 25.6-97 .9c-31.7-28.2-32.4-77.4-1.6-106.5l70.1-66.2C303.2 78.4 339.4 64 377.1 64c36.1 0 71 13.3 97.9 37.2L505.1 128H544h40 40c8.8 0 16 7.2 16 16V352c0 17.7-14.3 32-32 32H576c-11.8 0-22.2-6.4-27.7-16H463.4c-3.4 6.7-7.9 13.1-13.5 18.7c-17.1 17.1-40.8 23.8-63 20.1c-3.6 7.3-8.5 14.1-14.6 20.2c-27.3 27.3-70 30-100.4 8.1c-25.1 20.8-62.5 19.5-86-4.1L159 404l-7-7-35.6-35.6c-5.5-5.5-12.7-8.7-20.4-9.3C96 369.7 81.6 384 64 384H32c-17.7 0-32-14.3-32-32V144c0-8.8 7.2-16 16-16H56 96h19.8c2 0 3.9-.7 5.3-2l26.5-23.6C175.5 77.7 211.4 64 248.7 64H259c4.4 0 8.9 .2 13.2 .6zM544 320V176H496c-5.9 0-11.6-2.2-15.9-6.1l-36.9-32.8c-18.2-16.2-41.7-25.1-66.1-25.1c-25.4 0-49.8 9.7-68.3 27.1l-70.1 66.2c-10.3 9.8-10.1 26.3 .5 35.7c9.3 8.3 23.4 8.1 32.5-.3l71.9-66.4c9.7-9 24.9-8.4 33.9 1.4s8.4 24.9-1.4 33.9l-.8 .8 74.4 74.4c10 10 16.5 22.3 19.4 35.1H544zM64 336a16 16 0 1 0 -32 0 16 16 0 1 0 32 0zm528 16a16 16 0 1 0 0-32 16 16 0 1 0 0 32z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      B\u00e9n\u00e9ficiez de notre r\u00e9seau \n      <\/span>\n              <\/div>\n      \n    <\/li>\n\n  \n              \n    <li>\n              <div class='bde-icon-list__item-wrapper'>\n      \n      <span class='bde-icon-list__icon' aria-hidden='true'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.5.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M255.4 48.2c.2-.1 .4-.2 .6-.2s.4 .1 .6 .2L460.6 194c2.1 1.5 3.4 3.9 3.4 6.5v13.6L291.5 355.7c-20.7 17-50.4 17-71.1 0L48 214.1V200.5c0-2.6 1.2-5 3.4-6.5L255.4 48.2zM48 276.2L190 392.8c38.4 31.5 93.7 31.5 132 0L464 276.2V456c0 4.4-3.6 8-8 8H56c-4.4 0-8-3.6-8-8V276.2zM256 0c-10.2 0-20.2 3.2-28.5 9.1L23.5 154.9C8.7 165.4 0 182.4 0 200.5V456c0 30.9 25.1 56 56 56H456c30.9 0 56-25.1 56-56V200.5c0-18.1-8.7-35.1-23.4-45.6L284.5 9.1C276.2 3.2 266.2 0 256 0z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Support marketing inclus\n      <\/span>\n              <\/div>\n      \n    <\/li>\n\n  <\/ul>\n\n<\/div>\n<\/div><div class=\"bde-div-10814-116 bde-div\" data-entrance=\"slideUp\">\n  \n  \n\t\n\n\n\n<div class=\"bde-shortcode-10814-117 bde-shortcode\"><style id=\"wpforms-css-vars-12583\">\n\t\t\t\t#wpforms-12583 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n--wpforms-container-shadow-size-box-shadow: none;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full devenir-partenaire-form wpforms-render-modern\" id=\"wpforms-12583\"><form id=\"wpforms-form-12583\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"12583\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/10814?wpforms_form_id=12583\" data-token=\"20915fec50b772da65ee57359d12bf26\" data-token-time=\"1776693478\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-page-indicator progress\" data-indicator=\"progress\" data-indicator-color=\"#369f97\" data-scroll=\"1\" role=\"progressbar\" aria-valuenow=\"1\" aria-valuemin=\"1\" aria-valuemax=\"6\" tabindex=\"-1\"><span class=\"wpforms-page-indicator-page-title\" data-page-1-title=\"Devenir Partenaire\" data-page-2-title=\"Informations pratiques\" data-page-3-title=\"Exp\u00e9rience et r\u00e9f\u00e9rences\" data-page-4-title=\"Votre motivation\" data-page-5-title=\"Contact et documents\" data-page-6-title=\"Validation de votre candidature\">Devenir Partenaire<\/span><span class=\"wpforms-page-indicator-page-title-sep\" > - <\/span><span class=\"wpforms-page-indicator-steps\">Step <span class=\"wpforms-page-indicator-steps-current\">1<\/span> of 6<\/span><div class=\"wpforms-page-indicator-page-progress-wrap\"><div class=\"wpforms-page-indicator-page-progress\" style=\"width:16.666666666667%;background-color:#369f97\"><\/div><\/div><\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \" data-page=\"1\"><div id=\"wpforms-12583-field_1-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"1\"><\/div><div id=\"wpforms-12583-field_2-container\" class=\"wpforms-field wpforms-field-radio structure-selection wpforms-list-2-columns wpforms-conditional-trigger\" data-field-id=\"2\"><fieldset><legend class=\"wpforms-field-label\">Type de structure <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_2\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_2_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 384 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M48 0C21.5 0 0 21.5 0 48V464c0 26.5 21.5 48 48 48h96V432c0-26.5 21.5-48 48-48s48 21.5 48 48v80h96c26.5 0 48-21.5 48-48V48c0-26.5-21.5-48-48-48H48zM64 240c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V240zm112-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V240c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V240zM80 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V112zM272 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_2_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][2]\" value=\"Entreprise priv\u00e9e\" aria-errormessage=\"wpforms-12583-field_2_1-error\" aria-describedby=\"wpforms-12583-field_2-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Entreprise priv\u00e9e<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_2_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M72 88a56 56 0 1 1 112 0A56 56 0 1 1 72 88zM64 245.7C54 256.9 48 271.8 48 288s6 31.1 16 42.3V245.7zm144.4-49.3C178.7 222.7 160 261.2 160 304c0 34.3 12 65.8 32 90.5V416c0 17.7-14.3 32-32 32H96c-17.7 0-32-14.3-32-32V389.2C26.2 371.2 0 332.7 0 288c0-61.9 50.1-112 112-112h32c24 0 46.2 7.5 64.4 20.3zM448 416V394.5c20-24.7 32-56.2 32-90.5c0-42.8-18.7-81.3-48.4-107.7C449.8 183.5 472 176 496 176h32c61.9 0 112 50.1 112 112c0 44.7-26.2 83.2-64 101.2V416c0 17.7-14.3 32-32 32H480c-17.7 0-32-14.3-32-32zm8-328a56 56 0 1 1 112 0A56 56 0 1 1 456 88zM576 245.7v84.7c10-11.3 16-26.1 16-42.3s-6-31.1-16-42.3zM320 32a64 64 0 1 1 0 128 64 64 0 1 1 0-128zM240 304c0 16.2 6 31 16 42.3V261.7c-10 11.3-16 26.1-16 42.3zm144-42.3v84.7c10-11.3 16-26.1 16-42.3s-6-31.1-16-42.3zM448 304c0 44.7-26.2 83.2-64 101.2V448c0 17.7-14.3 32-32 32H288c-17.7 0-32-14.3-32-32V405.2c-37.8-18-64-56.5-64-101.2c0-61.9 50.1-112 112-112h32c61.9 0 112 50.1 112 112z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_2_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][2]\" value=\"Association\" aria-errormessage=\"wpforms-12583-field_2_2-error\" aria-describedby=\"wpforms-12583-field_2-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Association<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_2_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M224 256A128 128 0 1 1 224 0a128 128 0 1 1 0 256zM209.1 359.2l-18.6-31c-6.4-10.7 1.3-24.2 13.7-24.2H224h19.7c12.4 0 20.1 13.6 13.7 24.2l-18.6 31 33.4 123.9 36-146.9c2-8.1 9.8-13.4 17.9-11.3c70.1 17.6 121.9 81 121.9 156.4c0 17-13.8 30.7-30.7 30.7H285.5c-2.1 0-4-.4-5.8-1.1l.3 1.1H168l.3-1.1c-1.8 .7-3.8 1.1-5.8 1.1H30.7C13.8 512 0 498.2 0 481.3c0-75.5 51.9-138.9 121.9-156.4c8.1-2 15.9 3.3 17.9 11.3l36 146.9 33.4-123.9z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_2_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][2]\" value=\"Auto-entrepreneur\" aria-errormessage=\"wpforms-12583-field_2_3-error\" aria-describedby=\"wpforms-12583-field_2-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Auto-entrepreneur<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_2_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M480 0c-17.7 0-32 14.3-32 32V192 512h64V192H624c8.8 0 16-7.2 16-16V48c0-8.8-7.2-16-16-16H512c0-17.7-14.3-32-32-32zM416 159L276.8 39.7c-12-10.3-29.7-10.3-41.7 0l-224 192C1 240.4-2.7 254.5 2 267.1S18.6 288 32 288H64V480c0 17.7 14.3 32 32 32h64c17.7 0 32-14.3 32-32V384c0-17.7 14.3-32 32-32h64c17.7 0 32 14.3 32 32v96c0 17.7 14.3 32 32 32h64.7l.2 0h-1V159z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_2_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][2]\" value=\"Centre de loisirs\" aria-errormessage=\"wpforms-12583-field_2_4-error\" aria-describedby=\"wpforms-12583-field_2-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Centre de loisirs<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_2-description\" class=\"wpforms-field-description\">Statut juridique de votre organisation<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_3\">Nom de votre entreprise\/organisation <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-12583-field_3\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][3]\" placeholder=\"Ex: Adventure Park Brussels\" aria-errormessage=\"wpforms-12583-field_3-error\" aria-describedby=\"wpforms-12583-field_3-description\" required><div id=\"wpforms-12583-field_3-description\" class=\"wpforms-field-description\">D\u00e9nomination commerciale ou sociale<\/div><\/div><div id=\"wpforms-12583-field_4-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"4\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_4\">Num\u00e9ro d&#039;entreprise (BCE) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-12583-field_4\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"9999.999.999\" name=\"wpforms[fields][4]\" placeholder=\"Ex: 0123.456.789\" aria-errormessage=\"wpforms-12583-field_4-error\" aria-describedby=\"wpforms-12583-field_4-description\" required><div id=\"wpforms-12583-field_4-description\" class=\"wpforms-field-description\">Obligatoire pour les entreprises belges<\/div><\/div><div id=\"wpforms-12583-field_5-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"5\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_5\">Num\u00e9ro TVA<\/label><input type=\"text\" id=\"wpforms-12583-field_5\" class=\"wpforms-field-large\" name=\"wpforms[fields][5]\" placeholder=\"Ex: BE0123456789\" aria-errormessage=\"wpforms-12583-field_5-error\" aria-describedby=\"wpforms-12583-field_5-description\" ><div id=\"wpforms-12583-field_5-description\" class=\"wpforms-field-description\">Si applicable<\/div><\/div><div id=\"wpforms-12583-field_6-container\" class=\"wpforms-field wpforms-field-checkbox categories-selection wpforms-list-2-columns\" data-field-id=\"6\"><fieldset><legend class=\"wpforms-field-label\">Cat\u00e9gories d&#039;activit\u00e9s que vous proposez <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_6\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" data-choice-limit=\"5\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M448 256A192 192 0 1 0 64 256a192 192 0 1 0 384 0zM0 256a256 256 0 1 1 512 0A256 256 0 1 1 0 256zm256 80a80 80 0 1 0 0-160 80 80 0 1 0 0 160zm0-224a144 144 0 1 1 0 288 144 144 0 1 1 0-288zM224 256a32 32 0 1 1 64 0 32 32 0 1 1 -64 0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_1\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Action &amp; Adr\u00e9naline (Paintball, Laser Game, Tir \u00e0 l&#039;arc)\" aria-errormessage=\"wpforms-12583-field_6_1-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Action &amp; Adr\u00e9naline (Paintball, Laser Game, Tir \u00e0 l'arc)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M576 64H64C28.7 64 0 92.7 0 128V384c0 35.3 28.7 64 64 64H184.4c24.2 0 46.4-13.7 57.2-35.4l32-64c8.8-17.5 26.7-28.6 46.3-28.6s37.5 11.1 46.3 28.6l32 64c10.8 21.7 33 35.4 57.2 35.4H576c35.3 0 64-28.7 64-64V128c0-35.3-28.7-64-64-64zM96 240a64 64 0 1 1 128 0A64 64 0 1 1 96 240zm384-64a64 64 0 1 1 0 128 64 64 0 1 1 0-128z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_2\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"R\u00e9alit\u00e9 Virtuelle (VR Games, Simulateurs)\" aria-errormessage=\"wpforms-12583-field_6_2-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">R\u00e9alit\u00e9 Virtuelle (VR Games, Simulateurs)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M192 104.8c0-9.2-5.8-17.3-13.2-22.8C167.2 73.3 160 61.3 160 48c0-26.5 28.7-48 64-48s64 21.5 64 48c0 13.3-7.2 25.3-18.8 34c-7.4 5.5-13.2 13.6-13.2 22.8v0c0 12.8 10.4 23.2 23.2 23.2H336c26.5 0 48 21.5 48 48v56.8c0 12.8 10.4 23.2 23.2 23.2v0c9.2 0 17.3-5.8 22.8-13.2c8.7-11.6 20.7-18.8 34-18.8c26.5 0 48 28.7 48 64s-21.5 64-48 64c-13.3 0-25.3-7.2-34-18.8c-5.5-7.4-13.6-13.2-22.8-13.2v0c-12.8 0-23.2 10.4-23.2 23.2V464c0 26.5-21.5 48-48 48H279.2c-12.8 0-23.2-10.4-23.2-23.2v0c0-9.2 5.8-17.3 13.2-22.8c11.6-8.7 18.8-20.7 18.8-34c0-26.5-28.7-48-64-48s-64 21.5-64 48c0 13.3 7.2 25.3 18.8 34c7.4 5.5 13.2 13.6 13.2 22.8v0c0 12.8-10.4 23.2-23.2 23.2H48c-26.5 0-48-21.5-48-48V343.2C0 330.4 10.4 320 23.2 320v0c9.2 0 17.3 5.8 22.8 13.2C54.7 344.8 66.7 352 80 352c26.5 0 48-28.7 48-64s-21.5-64-48-64c-13.3 0-25.3 7.2-34 18.8C40.5 250.2 32.4 256 23.2 256v0C10.4 256 0 245.6 0 232.8V176c0-26.5 21.5-48 48-48H168.8c12.8 0 23.2-10.4 23.2-23.2v0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_3\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"D\u00e9fis &amp; \u00c9nigmes (Escape Games, Quiz, Chasses au tr\u00e9sor)\" aria-errormessage=\"wpforms-12583-field_6_3-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">D\u00e9fis &amp; \u00c9nigmes (Escape Games, Quiz, Chasses au tr\u00e9sor)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M320 48a48 48 0 1 0 -96 0 48 48 0 1 0 96 0zM125.7 175.5c9.9-9.9 23.4-15.5 37.5-15.5c1.9 0 3.8 .1 5.6 .3L137.6 254c-9.3 28 1.7 58.8 26.8 74.5l86.2 53.9-25.4 88.8c-4.9 17 5 34.7 22 39.6s34.7-5 39.6-22l28.7-100.4c5.9-20.6-2.6-42.6-20.7-53.9L238 299l30.9-82.4 5.1 12.3C289 264.7 323.9 288 362.7 288H384c17.7 0 32-14.3 32-32s-14.3-32-32-32H362.7c-12.9 0-24.6-7.8-29.5-19.7l-6.3-15c-14.6-35.1-44.1-61.9-80.5-73.1l-48.7-15c-11.1-3.4-22.7-5.2-34.4-5.2c-31 0-60.8 12.3-82.7 34.3L57.4 153.4c-12.5 12.5-12.5 32.8 0 45.3s32.8 12.5 45.3 0l23.1-23.1zM91.2 352H32c-17.7 0-32 14.3-32 32s14.3 32 32 32h69.6c19 0 36.2-11.2 43.9-28.5L157 361.6l-9.5-6c-17.5-10.9-30.5-26.8-37.9-44.9L91.2 352z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_4\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Sports &amp; Comp\u00e9tition (Karting, Padel, Golf, Badminton)\" aria-errormessage=\"wpforms-12583-field_6_4-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Sports &amp; Comp\u00e9tition (Karting, Padel, Golf, Badminton)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M192 64C86 64 0 150 0 256S86 448 192 448H448c106 0 192-86 192-192s-86-192-192-192H192zM496 168a40 40 0 1 1 0 80 40 40 0 1 1 0-80zM392 304a40 40 0 1 1 80 0 40 40 0 1 1 -80 0zM168 200c0-13.3 10.7-24 24-24s24 10.7 24 24v32h32c13.3 0 24 10.7 24 24s-10.7 24-24 24H216v32c0 13.3-10.7 24-24 24s-24-10.7-24-24V280H136c-13.3 0-24-10.7-24-24s10.7-24 24-24h32V200z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_5\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Famille &amp; Fun (Arcade, Bowling, Aires de jeux)\" aria-errormessage=\"wpforms-12583-field_6_5-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Famille &amp; Fun (Arcade, Bowling, Aires de jeux)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-6 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_6\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M210.6 5.9L62 169.4c-3.9 4.2-6 9.8-6 15.5C56 197.7 66.3 208 79.1 208H104L30.6 281.4c-4.2 4.2-6.6 10-6.6 16C24 309.9 34.1 320 46.6 320H80L5.4 409.5C1.9 413.7 0 419 0 424.5c0 13 10.5 23.5 23.5 23.5H192v32c0 17.7 14.3 32 32 32s32-14.3 32-32V448H424.5c13 0 23.5-10.5 23.5-23.5c0-5.5-1.9-10.8-5.4-15L368 320h33.4c12.5 0 22.6-10.1 22.6-22.6c0-6-2.4-11.8-6.6-16L344 208h24.9c12.7 0 23.1-10.3 23.1-23.1c0-5.7-2.1-11.3-6-15.5L237.4 5.9C234 2.1 229.1 0 224 0s-10 2.1-13.4 5.9z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_6\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Activit\u00e9s Nature (Aventure outdoor, Parcours)\" aria-errormessage=\"wpforms-12583-field_6_6-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Activit\u00e9s Nature (Aventure outdoor, Parcours)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-7 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_7\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M512 256c0 .9 0 1.8 0 2.7c-.4 36.5-33.6 61.3-70.1 61.3H344c-26.5 0-48 21.5-48 48c0 3.4 .4 6.7 1 9.9c2.1 10.2 6.5 20 10.8 29.9c6.1 13.8 12.1 27.5 12.1 42c0 31.8-21.6 60.7-53.4 62c-3.5 .1-7 .2-10.6 .2C114.6 512 0 397.4 0 256S114.6 0 256 0S512 114.6 512 256zM128 288a32 32 0 1 0 -64 0 32 32 0 1 0 64 0zm0-96a32 32 0 1 0 0-64 32 32 0 1 0 0 64zM288 96a32 32 0 1 0 -64 0 32 32 0 1 0 64 0zm96 96a32 32 0 1 0 0-64 32 32 0 1 0 0 64z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_7\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Cr\u00e9atives &amp; Artistiques (Ateliers, Workshops)\" aria-errormessage=\"wpforms-12583-field_6_7-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Cr\u00e9atives &amp; Artistiques (Ateliers, Workshops)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-8 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_8\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M416 0C400 0 288 32 288 176V288c0 35.3 28.7 64 64 64h32V480c0 17.7 14.3 32 32 32s32-14.3 32-32V352 240 32c0-17.7-14.3-32-32-32zM64 16C64 7.8 57.9 1 49.7 .1S34.2 4.6 32.4 12.5L2.1 148.8C.7 155.1 0 161.5 0 167.9c0 45.9 35.1 83.6 80 87.7V480c0 17.7 14.3 32 32 32s32-14.3 32-32V255.6c44.9-4.1 80-41.8 80-87.7c0-6.4-.7-12.8-2.1-19.1L191.6 12.5c-1.8-8-9.3-13.3-17.4-12.4S160 7.8 160 16V150.2c0 5.4-4.4 9.8-9.8 9.8c-5.1 0-9.3-3.9-9.8-9L127.9 14.6C127.2 6.3 120.3 0 112 0s-15.2 6.3-15.9 14.6L83.7 151c-.5 5.1-4.7 9-9.8 9c-5.4 0-9.8-4.4-9.8-9.8V16zm48.3 152l-.3 0-.3 0 .3-.7 .3 .7z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_8\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Gastronomie &amp; D\u00e9gustation\" aria-errormessage=\"wpforms-12583-field_6_8-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Gastronomie &amp; D\u00e9gustation<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-9 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_9\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 576 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M575.8 255.5c0 18-15 32.1-32 32.1h-32l.7 160.2c0 2.7-.2 5.4-.5 8.1V472c0 22.1-17.9 40-40 40H456c-1.1 0-2.2 0-3.3-.1c-1.4 .1-2.8 .1-4.2 .1H416 392c-22.1 0-40-17.9-40-40V448 384c0-17.7-14.3-32-32-32H256c-17.7 0-32 14.3-32 32v64 24c0 22.1-17.9 40-40 40H160 128.1c-1.5 0-3-.1-4.5-.2c-1.2 .1-2.4 .2-3.6 .2H104c-22.1 0-40-17.9-40-40V360c0-.9 0-1.9 .1-2.8V287.6H32c-18 0-32-14-32-32.1c0-9 3-17 10-24L266.4 8c7-7 15-8 22-8s15 2 21 7L564.8 231.5c8 7 12 15 11 24z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_9\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Animations \u00e0 domicile\" aria-errormessage=\"wpforms-12583-field_6_9-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Animations \u00e0 domicile<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-10 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_10\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M50.7 58.5L0 160H208V32H93.7C75.5 32 58.9 42.3 50.7 58.5zM240 160H448L397.3 58.5C389.1 42.3 372.5 32 354.3 32H240V160zm208 32H0V416c0 35.3 28.7 64 64 64H384c35.3 0 64-28.7 64-64V192z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_10\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Location de mat\u00e9riel\" aria-errormessage=\"wpforms-12583-field_6_10-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Location de mat\u00e9riel<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-11 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_6_11\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M8 256a56 56 0 1 1 112 0A56 56 0 1 1 8 256zm160 0a56 56 0 1 1 112 0 56 56 0 1 1 -112 0zm216-56a56 56 0 1 1 0 112 56 56 0 1 1 0-112z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_6_11\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][6][]\" value=\"Autre (pr\u00e9cisez dans le message)\" aria-errormessage=\"wpforms-12583-field_6_11-error\" aria-describedby=\"wpforms-12583-field_6-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Autre (pr\u00e9cisez dans le message)<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_6-description\" class=\"wpforms-field-description\">S\u00e9lectionnez toutes les cat\u00e9gories qui correspondent (max 5)<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_7-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_7\">D\u00e9tail de vos activit\u00e9s <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-12583-field_7\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][7]\" placeholder=\"Ex: Paintball outdoor (3 terrains th\u00e9matiques), Laser Game (ar\u00e8ne 400m\u00b2), Tir \u00e0 l&#039;arc traditionnel et compound...\" aria-errormessage=\"wpforms-12583-field_7-error\" aria-describedby=\"wpforms-12583-field_7-description\" required><\/textarea><div id=\"wpforms-12583-field_7-description\" class=\"wpforms-field-description\">Listez pr\u00e9cis\u00e9ment les activit\u00e9s que vous proposez<\/div><\/div><div id=\"wpforms-12583-field_8-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"8\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"1\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2  \" data-page=\"2\" style=\"display:none;\"><div id=\"wpforms-12583-field_9-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"9\"><fieldset><legend class=\"wpforms-field-label\">Adresse de votre \u00e9tablissement principal <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-12583-field_9\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][9][address1]\" placeholder=\"Rue et num\u00e9ro\" aria-errormessage=\"wpforms-12583-field_9-error\" aria-describedby=\"wpforms-12583-field_9-description\" required><label for=\"wpforms-12583-field_9\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-12583-field_9-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][9][address2]\" placeholder=\"Compl\u00e9ment d&#039;adresse\" aria-errormessage=\"wpforms-12583-field_9-address2-error\" aria-describedby=\"wpforms-12583-field_9-description\" ><label for=\"wpforms-12583-field_9-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-12583-field_9-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][9][city]\" placeholder=\"Ville\" aria-errormessage=\"wpforms-12583-field_9-city-error\" aria-describedby=\"wpforms-12583-field_9-description\" required><label for=\"wpforms-12583-field_9-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-12583-field_9-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][9][state]\" placeholder=\"Province\" aria-errormessage=\"wpforms-12583-field_9-state-error\" aria-describedby=\"wpforms-12583-field_9-description\" required><label for=\"wpforms-12583-field_9-state\" class=\"wpforms-field-sublabel after\">State \/ Province \/ Region<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-12583-field_9-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][9][postal]\" placeholder=\"Code postal\" aria-errormessage=\"wpforms-12583-field_9-postal-error\" aria-describedby=\"wpforms-12583-field_9-description\" required><label for=\"wpforms-12583-field_9-postal\" class=\"wpforms-field-sublabel after\">Postal Code<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-12583-field_9-country\" class=\"wpforms-field-address-country wpforms-field-required\" name=\"wpforms[fields][9][country]\" value=\"BE\" aria-errormessage=\"wpforms-12583-field_9-country-error\" aria-describedby=\"wpforms-12583-field_9-description\" required><option value=\"AF\" >Afghanistan<\/option><option value=\"AL\" >Albania<\/option><option value=\"DZ\" >Algeria<\/option><option value=\"AS\" >American Samoa<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguilla<\/option><option value=\"AQ\" >Antarctica<\/option><option value=\"AG\" >Antigua and Barbuda<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaijan<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BH\" >Bahrain<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BY\" >Belarus<\/option><option value=\"BE\"  selected='selected'>Belgium<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Benin<\/option><option value=\"BM\" >Bermuda<\/option><option value=\"BT\" >Bhutan<\/option><option value=\"BO\" >Bolivia (Plurinational State of)<\/option><option value=\"BQ\" >Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"BW\" >Botswana<\/option><option value=\"BV\" >Bouvet Island<\/option><option value=\"BR\" >Brazil<\/option><option value=\"IO\" >British Indian Ocean Territory<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Cambodia<\/option><option value=\"CM\" >Cameroon<\/option><option value=\"CA\" >Canada<\/option><option value=\"KY\" >Cayman Islands<\/option><option value=\"CF\" >Central African Republic<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CX\" >Christmas Island<\/option><option value=\"CC\" >Cocos (Keeling) Islands<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoros<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Democratic Republic of the)<\/option><option value=\"CK\" >Cook Islands<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"HR\" >Croatia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Cura\u00e7ao<\/option><option value=\"CY\" >Cyprus<\/option><option value=\"CZ\" >Czech Republic<\/option><option value=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"DK\" >Denmark<\/option><option value=\"DJ\" >Djibouti<\/option><option value=\"DM\" >Dominica<\/option><option value=\"DO\" >Dominican Republic<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egypt<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"GQ\" >Equatorial Guinea<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"EE\" >Estonia<\/option><option value=\"SZ\" >Eswatini (Kingdom of)<\/option><option value=\"ET\" >Ethiopia<\/option><option value=\"FK\" >Falkland Islands (Malvinas)<\/option><option value=\"FO\" >Faroe Islands<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"FI\" >Finland<\/option><option value=\"FR\" >France<\/option><option value=\"GF\" >French Guiana<\/option><option value=\"PF\" >French Polynesia<\/option><option value=\"TF\" >French Southern Territories<\/option><option value=\"GA\" >Gabon<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"DE\" >Germany<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GR\" >Greece<\/option><option value=\"GL\" >Greenland<\/option><option value=\"GD\" >Grenada<\/option><option value=\"GP\" >Guadeloupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GW\" >Guinea-Bissau<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Haiti<\/option><option value=\"HM\" >Heard Island and McDonald Islands<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungary<\/option><option value=\"IS\" >Iceland<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IR\" >Iran (Islamic Republic of)<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Ireland (Republic of)<\/option><option value=\"IM\" >Isle of Man<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italy<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Japan<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordan<\/option><option value=\"KZ\" >Kazakhstan<\/option><option value=\"KE\" >Kenya<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"KP\" >Korea (Democratic People&#039;s Republic of)<\/option><option value=\"KR\" >Korea (Republic of)<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"KG\" >Kyrgyzstan<\/option><option value=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"LV\" >Latvia<\/option><option value=\"LB\" >Lebanon<\/option><option value=\"LS\" >Lesotho<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libya<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lithuania<\/option><option value=\"LU\" >Luxembourg<\/option><option value=\"MO\" >Macao<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MW\" >Malawi<\/option><option value=\"MY\" >Malaysia<\/option><option value=\"MV\" >Maldives<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MH\" >Marshall Islands<\/option><option value=\"MQ\" >Martinique<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"MU\" >Mauritius<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"MX\" >Mexico<\/option><option value=\"FM\" >Micronesia (Federated States of)<\/option><option value=\"MD\" >Moldova (Republic of)<\/option><option value=\"MC\" >Monaco<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MA\" >Morocco<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NL\" >Netherlands<\/option><option value=\"NC\" >New Caledonia<\/option><option value=\"NZ\" >New Zealand<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NE\" >Niger<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NF\" >Norfolk Island<\/option><option value=\"MK\" >North Macedonia (Republic of)<\/option><option value=\"MP\" >Northern Mariana Islands<\/option><option value=\"NO\" >Norway<\/option><option value=\"OM\" >Oman<\/option><option value=\"PK\" >Pakistan<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestine (State of)<\/option><option value=\"PA\" >Panama<\/option><option value=\"PG\" >Papua New Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"PE\" >Peru<\/option><option value=\"PH\" >Philippines<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PL\" >Poland<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"QA\" >Qatar<\/option><option value=\"RO\" >Romania<\/option><option value=\"RU\" >Russian Federation<\/option><option value=\"RW\" >Rwanda<\/option><option value=\"RE\" >R\u00e9union<\/option><option value=\"BL\" >Saint Barth\u00e9lemy<\/option><option value=\"SH\" >Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"LC\" >Saint Lucia<\/option><option value=\"MF\" >Saint Martin (French part)<\/option><option value=\"PM\" >Saint Pierre and Miquelon<\/option><option value=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"WS\" >Samoa<\/option><option value=\"SM\" >San Marino<\/option><option value=\"ST\" >Sao Tome and Principe<\/option><option value=\"SA\" >Saudi Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leone<\/option><option value=\"SG\" >Singapore<\/option><option value=\"SX\" >Sint Maarten (Dutch part)<\/option><option value=\"SK\" >Slovakia<\/option><option value=\"SI\" >Slovenia<\/option><option value=\"SB\" >Solomon Islands<\/option><option value=\"SO\" >Somalia<\/option><option value=\"ZA\" >South Africa<\/option><option value=\"GS\" >South Georgia and the South Sandwich Islands<\/option><option value=\"SS\" >South Sudan<\/option><option value=\"ES\" >Spain<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SD\" >Sudan<\/option><option value=\"SR\" >Suriname<\/option><option value=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"SE\" >Sweden<\/option><option value=\"CH\" >Switzerland<\/option><option value=\"SY\" >Syrian Arab Republic<\/option><option value=\"TW\" >Taiwan, Republic of China<\/option><option value=\"TJ\" >Tajikistan<\/option><option value=\"TZ\" >Tanzania (United Republic of)<\/option><option value=\"TH\" >Thailand<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad and Tobago<\/option><option value=\"TN\" >Tunisia<\/option><option value=\"TM\" >Turkmenistan<\/option><option value=\"TC\" >Turks and Caicos Islands<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UA\" >Ukraine<\/option><option value=\"AE\" >United Arab Emirates<\/option><option value=\"GB\" >United Kingdom of Great Britain and Northern Ireland<\/option><option value=\"UM\" >United States Minor Outlying Islands<\/option><option value=\"US\" >United States of America<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekistan<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VA\" >Vatican City State<\/option><option value=\"VE\" >Venezuela (Bolivarian Republic of)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"VG\" >Virgin Islands (British)<\/option><option value=\"VI\" >Virgin Islands (U.S.)<\/option><option value=\"WF\" >Wallis and Futuna<\/option><option value=\"EH\" >Western Sahara<\/option><option value=\"YE\" >Yemen<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabwe<\/option><option value=\"AX\" >\u00c5land Islands<\/option><\/select><label for=\"wpforms-12583-field_9-country\" class=\"wpforms-field-sublabel after\">Country<\/label><\/div><\/div><div id=\"wpforms-12583-field_9-description\" class=\"wpforms-field-description\">Lieu o\u00f9 se d\u00e9roulent vos activit\u00e9s<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_10-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-2-columns wpforms-conditional-trigger\" data-field-id=\"10\"><fieldset><legend class=\"wpforms-field-label\">Zone de couverture <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_10\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_10_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 384 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M48 0C21.5 0 0 21.5 0 48V464c0 26.5 21.5 48 48 48h96V432c0-26.5 21.5-48 48-48s48 21.5 48 48v80h96c26.5 0 48-21.5 48-48V48c0-26.5-21.5-48-48-48H48zM64 240c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V240zm112-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V240c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V240zM80 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V112zM272 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_10_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][10]\" value=\"Uniquement sur site (clients viennent chez nous)\" aria-errormessage=\"wpforms-12583-field_10_1-error\" aria-describedby=\"wpforms-12583-field_10-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Uniquement sur site (clients viennent chez nous)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_10_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M64 104v88h96V96H72c-4.4 0-8 3.6-8 8zm482 88L465.1 96H384v96H546zm-226 0V96H224v96h96zM592 384H576c0 53-43 96-96 96s-96-43-96-96H256c0 53-43 96-96 96s-96-43-96-96H48c-26.5 0-48-21.5-48-48V104C0 64.2 32.2 32 72 32H192 352 465.1c18.9 0 36.8 8.3 49 22.8L625 186.5c9.7 11.5 15 26.1 15 41.2V336c0 26.5-21.5 48-48 48zm-64 0a48 48 0 1 0 -96 0 48 48 0 1 0 96 0zM160 432a48 48 0 1 0 0-96 48 48 0 1 0 0 96z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_10_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][10]\" value=\"D\u00e9placements possibles (rayon limit\u00e9)\" aria-errormessage=\"wpforms-12583-field_10_2-error\" aria-describedby=\"wpforms-12583-field_10-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">D\u00e9placements possibles (rayon limit\u00e9)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_10_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M266.3 48.3L232.5 73.6c-5.4 4-8.5 10.4-8.5 17.1v9.1c0 6.8 5.5 12.3 12.3 12.3c2.4 0 4.8-.7 6.8-2.1l41.8-27.9c2-1.3 4.4-2.1 6.8-2.1h1c6.2 0 11.3 5.1 11.3 11.3c0 3-1.2 5.9-3.3 8l-19.9 19.9c-5.8 5.8-12.9 10.2-20.7 12.8l-26.5 8.8c-5.8 1.9-9.6 7.3-9.6 13.4c0 3.7-1.5 7.3-4.1 10l-17.9 17.9c-6.4 6.4-9.9 15-9.9 24v4.3c0 16.4 13.6 29.7 29.9 29.7c11 0 21.2-6.2 26.1-16l4-8.1c2.4-4.8 7.4-7.9 12.8-7.9c4.5 0 8.7 2.1 11.4 5.7l16.3 21.7c2.1 2.9 5.5 4.5 9.1 4.5c8.4 0 13.9-8.9 10.1-16.4l-1.1-2.3c-3.5-7 0-15.5 7.5-18l21.2-7.1c7.6-2.5 12.7-9.6 12.7-17.6c0-10.3 8.3-18.6 18.6-18.6H400c8.8 0 16 7.2 16 16s-7.2 16-16 16H379.3c-7.2 0-14.2 2.9-19.3 8l-4.7 4.7c-2.1 2.1-3.3 5-3.3 8c0 6.2 5.1 11.3 11.3 11.3h11.3c6 0 11.8 2.4 16 6.6l6.5 6.5c1.8 1.8 2.8 4.3 2.8 6.8s-1 5-2.8 6.8l-7.5 7.5C386 262 384 266.9 384 272s2 10 5.7 13.7L408 304c10.2 10.2 24.1 16 38.6 16H454c6.5-20.2 10-41.7 10-64c0-111.4-87.6-202.4-197.7-207.7zm172 307.9c-3.7-2.6-8.2-4.1-13-4.1c-6 0-11.8-2.4-16-6.6L396 332c-7.7-7.7-18-12-28.9-12c-9.7 0-19.2-3.5-26.6-9.8L314 287.4c-11.6-9.9-26.4-15.4-41.7-15.4H251.4c-12.6 0-25 3.7-35.5 10.7L188.5 301c-17.8 11.9-28.5 31.9-28.5 53.3v3.2c0 17 6.7 33.3 18.7 45.3l16 16c8.5 8.5 20 13.3 32 13.3H248c13.3 0 24 10.7 24 24c0 2.5 .4 5 1.1 7.3c71.3-5.8 132.5-47.6 165.2-107.2zM0 256a256 256 0 1 1 512 0A256 256 0 1 1 0 256zM187.3 100.7c-6.2-6.2-16.4-6.2-22.6 0l-32 32c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0l32-32c6.2-6.2 6.2-16.4 0-22.6z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_10_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][10]\" value=\"D\u00e9placements \u00e9tendus (toute la Belgique)\" aria-errormessage=\"wpforms-12583-field_10_3-error\" aria-describedby=\"wpforms-12583-field_10-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">D\u00e9placements \u00e9tendus (toute la Belgique)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_10_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 576 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M575.8 255.5c0 18-15 32.1-32 32.1h-32l.7 160.2c0 2.7-.2 5.4-.5 8.1V472c0 22.1-17.9 40-40 40H456c-1.1 0-2.2 0-3.3-.1c-1.4 .1-2.8 .1-4.2 .1H416 392c-22.1 0-40-17.9-40-40V448 384c0-17.7-14.3-32-32-32H256c-17.7 0-32 14.3-32 32v64 24c0 22.1-17.9 40-40 40H160 128.1c-1.5 0-3-.1-4.5-.2c-1.2 .1-2.4 .2-3.6 .2H104c-22.1 0-40-17.9-40-40V360c0-.9 0-1.9 .1-2.8V287.6H32c-18 0-32-14-32-32.1c0-9 3-17 10-24L266.4 8c7-7 15-8 22-8s15 2 21 7L564.8 231.5c8 7 12 15 11 24z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_10_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][10]\" value=\"Uniquement \u00e0 domicile\/sur site client\" aria-errormessage=\"wpforms-12583-field_10_4-error\" aria-describedby=\"wpforms-12583-field_10-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Uniquement \u00e0 domicile\/sur site client<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_10-description\" class=\"wpforms-field-description\">Comment proposez-vous vos services ?<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_11-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"11\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_11\">P\u00e9rim\u00e8tre de d\u00e9placement <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-12583-field_11\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][11]\" placeholder=\"Pr\u00e9cisez votre zone d&#039;intervention\" aria-errormessage=\"wpforms-12583-field_11-error\" aria-describedby=\"wpforms-12583-field_11-description\" required><div id=\"wpforms-12583-field_11-description\" class=\"wpforms-field-description\">Ex: 50 km autour de Bruxelles, Province du Brabant Wallon...<\/div><\/div><div id=\"wpforms-12583-field_12-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_12\">Capacit\u00e9 d&#039;accueil maximale <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-12583-field_12\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][12]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>S\u00e9lectionnez la capacit\u00e9...<\/option><option value=\"1-10 personnes\"  class=\"choice-1 depth-1\"  >1-10 personnes<\/option><option value=\"10-25 personnes\"  class=\"choice-2 depth-1\"  >10-25 personnes<\/option><option value=\"25-50 personnes\"  class=\"choice-3 depth-1\"  >25-50 personnes<\/option><option value=\"50-100 personnes\"  class=\"choice-4 depth-1\"  >50-100 personnes<\/option><option value=\"100-200 personnes\"  class=\"choice-5 depth-1\"  >100-200 personnes<\/option><option value=\"Plus de 200 personnes\"  class=\"choice-6 depth-1\"  >Plus de 200 personnes<\/option><\/select><div id=\"wpforms-12583-field_12-description\" class=\"wpforms-field-description\">Pour vos plus grandes activit\u00e9s<\/div><\/div><div id=\"wpforms-12583-field_13-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_13\">Gamme de prix principale <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-12583-field_13\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][13]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>S\u00e9lectionnez la gamme...<\/option><option value=\"Moins de 15\u20ac\/personne\"  class=\"choice-1 depth-1\"  >Moins de 15\u20ac\/personne<\/option><option value=\"15\u20ac - 30\u20ac\/personne\"  class=\"choice-2 depth-1\"  >15\u20ac - 30\u20ac\/personne<\/option><option value=\"30\u20ac - 50\u20ac\/personne\"  class=\"choice-3 depth-1\"  >30\u20ac - 50\u20ac\/personne<\/option><option value=\"50\u20ac - 100\u20ac\/personne\"  class=\"choice-4 depth-1\"  >50\u20ac - 100\u20ac\/personne<\/option><option value=\"Plus de 100\u20ac\/personne\"  class=\"choice-5 depth-1\"  >Plus de 100\u20ac\/personne<\/option><option value=\"Tarifs forfaitaires groupe\"  class=\"choice-6 depth-1\"  >Tarifs forfaitaires groupe<\/option><\/select><div id=\"wpforms-12583-field_13-description\" class=\"wpforms-field-description\">Tarif moyen de vos prestations<\/div><\/div><div id=\"wpforms-12583-field_14-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-3-columns\" data-field-id=\"14\"><fieldset><legend class=\"wpforms-field-label\">Public cible <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_14\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 320 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M96 64a64 64 0 1 1 128 0A64 64 0 1 1 96 64zm48 320v96c0 17.7-14.3 32-32 32s-32-14.3-32-32V287.8L59.1 321c-9.4 15-29.2 19.4-44.1 10S-4.5 301.9 4.9 287l39.9-63.3C69.7 184 113.2 160 160 160s90.3 24 115.2 63.6L315.1 287c9.4 15 4.9 34.7-10 44.1s-34.7 4.9-44.1-10L240 287.8V480c0 17.7-14.3 32-32 32s-32-14.3-32-32V384H144z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"Enfants (3-12 ans)\" aria-errormessage=\"wpforms-12583-field_14_1-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Enfants (3-12 ans)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M320 32c-8.1 0-16.1 1.4-23.7 4.1L15.8 137.4C6.3 140.9 0 149.9 0 160s6.3 19.1 15.8 22.6l57.9 20.9C57.3 229.3 48 259.8 48 291.9v28.1c0 28.4-10.8 57.7-22.3 80.8c-6.5 13-13.9 25.8-22.5 37.6C0 442.7-.9 448.3 .9 453.4s6 8.9 11.2 10.2l64 16c4.2 1.1 8.7 .3 12.4-2s6.3-6.1 7.1-10.4c8.6-42.8 4.3-81.2-2.1-108.7C90.3 344.3 86 329.8 80 316.5V291.9c0-30.2 10.2-58.7 27.9-81.5c12.9-15.5 29.6-28 49.2-35.7l157-61.7c8.2-3.2 17.5 .8 20.7 9s-.8 17.5-9 20.7l-157 61.7c-12.4 4.9-23.3 12.4-32.2 21.6l159.6 57.6c7.6 2.7 15.6 4.1 23.7 4.1s16.1-1.4 23.7-4.1L624.2 182.6c9.5-3.4 15.8-12.5 15.8-22.6s-6.3-19.1-15.8-22.6L343.7 36.1C336.1 33.4 328.1 32 320 32zM128 408c0 35.3 86 72 192 72s192-36.7 192-72L496.7 262.6 354.5 314c-11.1 4-22.8 6-34.5 6s-23.5-2-34.5-6L143.3 262.6 128 408z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"Adolescents (13-17 ans)\" aria-errormessage=\"wpforms-12583-field_14_2-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Adolescents (13-17 ans)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M144 0a80 80 0 1 1 0 160A80 80 0 1 1 144 0zM512 0a80 80 0 1 1 0 160A80 80 0 1 1 512 0zM0 298.7C0 239.8 47.8 192 106.7 192h42.7c15.9 0 31 3.5 44.6 9.7c-1.3 7.2-1.9 14.7-1.9 22.3c0 38.2 16.8 72.5 43.3 96c-.2 0-.4 0-.7 0H21.3C9.6 320 0 310.4 0 298.7zM405.3 320c-.2 0-.4 0-.7 0c26.6-23.5 43.3-57.8 43.3-96c0-7.6-.7-15-1.9-22.3c13.6-6.3 28.7-9.7 44.6-9.7h42.7C592.2 192 640 239.8 640 298.7c0 11.8-9.6 21.3-21.3 21.3H405.3zM224 224a96 96 0 1 1 192 0 96 96 0 1 1 -192 0zM128 485.3C128 411.7 187.7 352 261.3 352H378.7C452.3 352 512 411.7 512 485.3c0 14.7-11.9 26.7-26.7 26.7H154.7c-14.7 0-26.7-11.9-26.7-26.7z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"Adultes (18+ ans)\" aria-errormessage=\"wpforms-12583-field_14_3-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Adultes (18+ ans)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M224 0a128 128 0 1 1 0 256A128 128 0 1 1 224 0zM178.3 304h91.4c20.6 0 40.4 3.5 58.8 9.9C323 331 320 349.1 320 368c0 59.5 29.5 112.1 74.8 144H29.7C13.3 512 0 498.7 0 482.3C0 383.8 79.8 304 178.3 304zM352 368a144 144 0 1 1 288 0 144 144 0 1 1 -288 0zm144-80c-8.8 0-16 7.2-16 16v64c0 8.8 7.2 16 16 16h48c8.8 0 16-7.2 16-16s-7.2-16-16-16H512V304c0-8.8-7.2-16-16-16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"Seniors (65+ ans)\" aria-errormessage=\"wpforms-12583-field_14_4-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Seniors (65+ ans)<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 384 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M48 0C21.5 0 0 21.5 0 48V464c0 26.5 21.5 48 48 48h96V432c0-26.5 21.5-48 48-48s48 21.5 48 48v80h96c26.5 0 48-21.5 48-48V48c0-26.5-21.5-48-48-48H48zM64 240c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V240zm112-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V240c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V240zM80 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16zm80 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H176c-8.8 0-16-7.2-16-16V112zM272 96h32c8.8 0 16 7.2 16 16v32c0 8.8-7.2 16-16 16H272c-8.8 0-16-7.2-16-16V112c0-8.8 7.2-16 16-16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_5\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"Entreprises\" aria-errormessage=\"wpforms-12583-field_14_5-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Entreprises<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-6 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_6\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M337.8 5.4C327-1.8 313-1.8 302.2 5.4L166.3 96H48C21.5 96 0 117.5 0 144V464c0 26.5 21.5 48 48 48H592c26.5 0 48-21.5 48-48V144c0-26.5-21.5-48-48-48H473.7L337.8 5.4zM256 416c0-35.3 28.7-64 64-64s64 28.7 64 64v96H256V416zM96 192h32c8.8 0 16 7.2 16 16v64c0 8.8-7.2 16-16 16H96c-8.8 0-16-7.2-16-16V208c0-8.8 7.2-16 16-16zm400 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v64c0 8.8-7.2 16-16 16H512c-8.8 0-16-7.2-16-16V208zM96 320h32c8.8 0 16 7.2 16 16v64c0 8.8-7.2 16-16 16H96c-8.8 0-16-7.2-16-16V336c0-8.8 7.2-16 16-16zm400 16c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16v64c0 8.8-7.2 16-16 16H512c-8.8 0-16-7.2-16-16V336zM232 176a88 88 0 1 1 176 0 88 88 0 1 1 -176 0zm88-48c-8.8 0-16 7.2-16 16v32c0 8.8 7.2 16 16 16h32c8.8 0 16-7.2 16-16s-7.2-16-16-16H336V144c0-8.8-7.2-16-16-16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_6\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"\u00c9coles &amp; Institutions\" aria-errormessage=\"wpforms-12583-field_14_6-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">\u00c9coles &amp; Institutions<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-7 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_14_7\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_14_7\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][14][]\" value=\"\u00c9v\u00e9nements priv\u00e9s\" aria-errormessage=\"wpforms-12583-field_14_7-error\" aria-describedby=\"wpforms-12583-field_14-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">\u00c9v\u00e9nements priv\u00e9s<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_14-description\" class=\"wpforms-field-description\">Qui sont vos clients types ? (plusieurs choix possibles)<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_15-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"15\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"2\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Pr\u00e9c\u00e9dent<\/button><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"2\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-3  \" data-page=\"3\" style=\"display:none;\"><div id=\"wpforms-12583-field_16-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-3-columns\" data-field-id=\"16\"><fieldset><legend class=\"wpforms-field-label\">Depuis quand exercez-vous cette activit\u00e9 ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_16\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_16_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M512 32c0 113.6-84.6 207.5-194.2 222c-7.1-53.4-30.6-101.6-65.3-139.3C290.8 46.3 364 0 448 0h32c17.7 0 32 14.3 32 32zM0 96C0 78.3 14.3 64 32 64H64c123.7 0 224 100.3 224 224v32V480c0 17.7-14.3 32-32 32s-32-14.3-32-32V320C100.3 320 0 219.7 0 96z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_16_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][16]\" value=\"Moins d&#039;1 an\" aria-errormessage=\"wpforms-12583-field_16_1-error\" aria-describedby=\"wpforms-12583-field_16-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Moins d'1 an<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_16_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M272 96c-78.6 0-145.1 51.5-167.7 122.5c33.6-17 71.5-26.5 111.7-26.5h88c8.8 0 16 7.2 16 16s-7.2 16-16 16H288 216s0 0 0 0c-16.6 0-32.7 1.9-48.2 5.4c-25.9 5.9-50 16.4-71.4 30.7c0 0 0 0 0 0C38.3 298.8 0 364.9 0 440v16c0 13.3 10.7 24 24 24s24-10.7 24-24V440c0-48.7 20.7-92.5 53.8-123.2C121.6 392.3 190.3 448 272 448l1 0c132.1-.7 239-130.9 239-291.4c0-42.6-7.5-83.1-21.1-119.6c-2.6-6.9-12.7-6.6-16.2-.1C455.9 72.1 418.7 96 376 96L272 96z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_16_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][16]\" value=\"1 \u00e0 3 ans\" aria-errormessage=\"wpforms-12583-field_16_2-error\" aria-describedby=\"wpforms-12583-field_16-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">1 \u00e0 3 ans<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_16_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M210.6 5.9L62 169.4c-3.9 4.2-6 9.8-6 15.5C56 197.7 66.3 208 79.1 208H104L30.6 281.4c-4.2 4.2-6.6 10-6.6 16C24 309.9 34.1 320 46.6 320H80L5.4 409.5C1.9 413.7 0 419 0 424.5c0 13 10.5 23.5 23.5 23.5H192v32c0 17.7 14.3 32 32 32s32-14.3 32-32V448H424.5c13 0 23.5-10.5 23.5-23.5c0-5.5-1.9-10.8-5.4-15L368 320h33.4c12.5 0 22.6-10.1 22.6-22.6c0-6-2.4-11.8-6.6-16L344 208h24.9c12.7 0 23.1-10.3 23.1-23.1c0-5.7-2.1-11.3-6-15.5L237.4 5.9C234 2.1 229.1 0 224 0s-10 2.1-13.4 5.9z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_16_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][16]\" value=\"3 \u00e0 5 ans\" aria-errormessage=\"wpforms-12583-field_16_3-error\" aria-describedby=\"wpforms-12583-field_16-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">3 \u00e0 5 ans<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_16_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M256 32c12.5 0 24.1 6.4 30.8 17L503.4 394.4c5.6 8.9 8.6 19.2 8.6 29.7c0 30.9-25 55.9-55.9 55.9H55.9C25 480 0 455 0 424.1c0-10.5 3-20.8 8.6-29.7L225.2 49c6.6-10.6 18.3-17 30.8-17zm65 192L256 120.4 176.9 246.5l18.3 24.4c6.4 8.5 19.2 8.5 25.6 0l25.6-34.1c6-8.1 15.5-12.8 25.6-12.8h49z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_16_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][16]\" value=\"5 \u00e0 10 ans\" aria-errormessage=\"wpforms-12583-field_16_4-error\" aria-describedby=\"wpforms-12583-field_16-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">5 \u00e0 10 ans<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_16_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 576 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M309 106c11.4-7 19-19.7 19-34c0-22.1-17.9-40-40-40s-40 17.9-40 40c0 14.4 7.6 27 19 34L209.7 220.6c-9.1 18.2-32.7 23.4-48.6 10.7L72 160c5-6.7 8-15 8-24c0-22.1-17.9-40-40-40S0 113.9 0 136s17.9 40 40 40c.2 0 .5 0 .7 0L86.4 427.4c5.5 30.4 32 52.6 63 52.6H426.6c30.9 0 57.4-22.1 63-52.6L535.3 176c.2 0 .5 0 .7 0c22.1 0 40-17.9 40-40s-17.9-40-40-40s-40 17.9-40 40c0 9 3 17.3 8 24l-89.1 71.3c-15.9 12.7-39.5 7.5-48.6-10.7L309 106z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_16_5\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][16]\" value=\"Plus de 10 ans\" aria-errormessage=\"wpforms-12583-field_16_5-error\" aria-describedby=\"wpforms-12583-field_16-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Plus de 10 ans<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_16-description\" class=\"wpforms-field-description\">Anciennet\u00e9 dans le secteur<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_17\">Taille de votre \u00e9quipe <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-12583-field_17\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>S\u00e9lectionnez la taille...<\/option><option value=\"Juste moi (solo)\"  class=\"choice-1 depth-1\"  >Juste moi (solo)<\/option><option value=\"2-5 personnes\"  class=\"choice-2 depth-1\"  >2-5 personnes<\/option><option value=\"6-10 personnes\"  class=\"choice-3 depth-1\"  >6-10 personnes<\/option><option value=\"11-20 personnes\"  class=\"choice-4 depth-1\"  >11-20 personnes<\/option><option value=\"Plus de 20 personnes\"  class=\"choice-5 depth-1\"  >Plus de 20 personnes<\/option><\/select><div id=\"wpforms-12583-field_17-description\" class=\"wpforms-field-description\">Nombre d'employ\u00e9s\/collaborateurs<\/div><\/div><div id=\"wpforms-12583-field_18-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_18\">Volume mensuel moyen <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-12583-field_18\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][18]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>S\u00e9lectionnez le volume...<\/option><option value=\"Moins de 50 clients\/mois\"  class=\"choice-1 depth-1\"  >Moins de 50 clients\/mois<\/option><option value=\"50-150 clients\/mois\"  class=\"choice-2 depth-1\"  >50-150 clients\/mois<\/option><option value=\"150-300 clients\/mois\"  class=\"choice-3 depth-1\"  >150-300 clients\/mois<\/option><option value=\"300-500 clients\/mois\"  class=\"choice-4 depth-1\"  >300-500 clients\/mois<\/option><option value=\"Plus de 500 clients\/mois\"  class=\"choice-5 depth-1\"  >Plus de 500 clients\/mois<\/option><option value=\"Variable selon saison\"  class=\"choice-6 depth-1\"  >Variable selon saison<\/option><\/select><div id=\"wpforms-12583-field_18-description\" class=\"wpforms-field-description\">Estimation de votre activit\u00e9<\/div><\/div><div id=\"wpforms-12583-field_19-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_19\">Principales r\u00e9f\u00e9rences clients<\/label><textarea id=\"wpforms-12583-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" placeholder=\"Ex: Team buildings pour Deloitte, anniversaires au Ch\u00e2teau de Versailles, partenariat avec Visit Brussels...\" aria-errormessage=\"wpforms-12583-field_19-error\" aria-describedby=\"wpforms-12583-field_19-description\" ><\/textarea><div id=\"wpforms-12583-field_19-description\" class=\"wpforms-field-description\">Exemples d'entreprises, \u00e9v\u00e9nements ou partenaires marquants (optionnel)<\/div><\/div><div id=\"wpforms-12583-field_20-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">Assurances et certifications <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_20\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-medium\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"60\" height=\"48px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M410.3 231l11.3-11.3-33.9-33.9-62.1-62.1L291.7 89.8l-11.3 11.3-22.6 22.6L58.6 322.9c-10.4 10.4-18 23.3-22.2 37.4L1 480.7c-2.5 8.4-.2 17.5 6.1 23.7s15.3 8.5 23.7 6.1l120.3-35.4c14.1-4.2 27-11.8 37.4-22.2L387.7 253.7 410.3 231zM160 399.4l-9.1 22.7c-4 3.1-8.5 5.4-13.3 6.9L59.4 452l23-78.1c1.4-4.9 3.8-9.4 6.9-13.3l22.7-9.1v32c0 8.8 7.2 16 16 16h32zM362.7 18.7L348.3 33.2 325.7 55.8 314.3 67.1l33.9 33.9 62.1 62.1 33.9 33.9 11.3-11.3 22.6-22.6 14.5-14.5c25-25 25-65.5 0-90.5L453.3 18.7c-25-25-65.5-25-90.5 0zm-47.4 168l-144 144c-6.2 6.2-16.4 6.2-22.6 0s-6.2-16.4 0-22.6l144-144c6.2-6.2 16.4-6.2 22.6 0s6.2 16.4 0 22.6z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"Assurance Responsabilit\u00e9 Civile Professionnelle\" aria-errormessage=\"wpforms-12583-field_20_1-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Assurance Responsabilit\u00e9 Civile Professionnelle<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"Assurance activit\u00e9s \u00e0 risque\" aria-errormessage=\"wpforms-12583-field_20_2-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Assurance activit\u00e9s \u00e0 risque<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"60\" height=\"48px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M211 7.3C205 1 196-1.4 187.6 .8s-14.9 8.9-17.1 17.3L154.7 80.6l-62-17.5c-8.4-2.4-17.4 0-23.5 6.1s-8.5 15.1-6.1 23.5l17.5 62L18.1 170.6c-8.4 2.1-15 8.7-17.3 17.1S1 205 7.3 211l46.2 45L7.3 301C1 307-1.4 316 .8 324.4s8.9 14.9 17.3 17.1l62.5 15.8-17.5 62c-2.4 8.4 0 17.4 6.1 23.5s15.1 8.5 23.5 6.1l62-17.5 15.8 62.5c2.1 8.4 8.7 15 17.1 17.3s17.3-.2 23.4-6.4l45-46.2 45 46.2c6.1 6.2 15 8.7 23.4 6.4s14.9-8.9 17.1-17.3l15.8-62.5 62 17.5c8.4 2.4 17.4 0 23.5-6.1s8.5-15.1 6.1-23.5l-17.5-62 62.5-15.8c8.4-2.1 15-8.7 17.3-17.1s-.2-17.3-6.4-23.4l-46.2-45 46.2-45c6.2-6.1 8.7-15 6.4-23.4s-8.9-14.9-17.3-17.1l-62.5-15.8 17.5-62c2.4-8.4 0-17.4-6.1-23.5s-15.1-8.5-23.5-6.1l-62 17.5L341.4 18.1c-2.1-8.4-8.7-15-17.1-17.3S307 1 301 7.3L256 53.5 211 7.3z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"Certifications s\u00e9curit\u00e9\/qualit\u00e9\" aria-errormessage=\"wpforms-12583-field_20_3-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Certifications s\u00e9curit\u00e9\/qualit\u00e9<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"60\" height=\"48px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M219.3 .5c3.1-.6 6.3-.6 9.4 0l200 40C439.9 42.7 448 52.6 448 64s-8.1 21.3-19.3 23.5L352 102.9V160c0 70.7-57.3 128-128 128s-128-57.3-128-128V102.9L48 93.3v65.1l15.7 78.4c.9 4.7-.3 9.6-3.3 13.3s-7.6 5.9-12.4 5.9H16c-4.8 0-9.3-2.1-12.4-5.9s-4.3-8.6-3.3-13.3L16 158.4V86.6C6.5 83.3 0 74.3 0 64C0 52.6 8.1 42.7 19.3 40.5l200-40zM111.9 327.7c10.5-3.4 21.8 .4 29.4 8.5l71 75.5c6.3 6.7 17 6.7 23.3 0l71-75.5c7.6-8.1 18.9-11.9 29.4-8.5C401 348.6 448 409.4 448 481.3c0 17-13.8 30.7-30.7 30.7H30.7C13.8 512 0 498.2 0 481.3c0-71.9 47-132.7 111.9-153.6z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"Personnel form\u00e9\/dipl\u00f4m\u00e9\" aria-errormessage=\"wpforms-12583-field_20_4-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Personnel form\u00e9\/dipl\u00f4m\u00e9<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_5\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"Mat\u00e9riel aux normes CE\" aria-errormessage=\"wpforms-12583-field_20_5-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Mat\u00e9riel aux normes CE<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-6 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_20_6\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"60\" height=\"48px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M256 0a256 256 0 1 1 0 512A256 256 0 1 1 256 0zM232 120V256c0 8 4 15.5 10.7 20l96 64c11 7.4 25.9 4.4 33.3-6.7s4.4-25.9-6.7-33.3L280 243.2V120c0-13.3-10.7-24-24-24s-24 10.7-24 24z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_20_6\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][20][]\" value=\"En cours d&#039;obtention\" aria-errormessage=\"wpforms-12583-field_20_6-error\" aria-describedby=\"wpforms-12583-field_20-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">En cours d'obtention<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_20-description\" class=\"wpforms-field-description\">\u00c9l\u00e9ments dont vous disposez (s\u00e9lectionnez tous ceux applicables)<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_21-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"21\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"3\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Pr\u00e9c\u00e9dent<\/button><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"3\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-4  \" data-page=\"4\" style=\"display:none;\"><div id=\"wpforms-12583-field_22-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_22\">Pourquoi souhaitez-vous rejoindre le r\u00e9seau Activit\u00e9s Bruxelles ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-12583-field_22\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][22]\" placeholder=\"Ex: D\u00e9velopper ma client\u00e8le, b\u00e9n\u00e9ficier de votre expertise marketing, proposer des activit\u00e9s compl\u00e9mentaires \u00e0 mes clients...\" aria-errormessage=\"wpforms-12583-field_22-error\" aria-describedby=\"wpforms-12583-field_22-description\" required><\/textarea><div id=\"wpforms-12583-field_22-description\" class=\"wpforms-field-description\">Parlez-nous de vos motivations et de ce que vous attendez de ce partenariat<\/div><\/div><div id=\"wpforms-12583-field_23-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-3-columns\" data-field-id=\"23\"><fieldset><legend class=\"wpforms-field-label\">Comment avez-vous d\u00e9couvert Activit\u00e9s Bruxelles ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_23\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M416 208c0 45.9-14.9 88.3-40 122.7L502.6 457.4c12.5 12.5 12.5 32.8 0 45.3s-32.8 12.5-45.3 0L330.7 376c-34.4 25.2-76.8 40-122.7 40C93.1 416 0 322.9 0 208S93.1 0 208 0S416 93.1 416 208zM208 352a144 144 0 1 0 0-288 144 144 0 1 0 0 288z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"Recherche Google\" aria-errormessage=\"wpforms-12583-field_23_1-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Recherche Google<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M96 128a128 128 0 1 1 256 0A128 128 0 1 1 96 128zM0 482.3C0 383.8 79.8 304 178.3 304h91.4C368.2 304 448 383.8 448 482.3c0 16.4-13.3 29.7-29.7 29.7H29.7C13.3 512 0 498.7 0 482.3zM609.3 512H471.4c5.4-9.4 8.6-20.3 8.6-32v-8c0-60.7-27.1-115.2-69.8-151.8c2.4-.1 4.7-.2 7.1-.2h61.4C567.8 320 640 392.2 640 481.3c0 17-13.8 30.7-30.7 30.7zM432 256c-31 0-59-12.6-79.3-32.9C372.4 196.5 384 163.6 384 128c0-26.8-6.6-52.1-18.3-74.3C384.3 40.1 407.2 32 432 32c61.9 0 112 50.1 112 112s-50.1 112-112 112z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"Recommandation d&#039;un partenaire\" aria-errormessage=\"wpforms-12583-field_23_2-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Recommandation d'un partenaire<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M352 224c53 0 96-43 96-96s-43-96-96-96s-96 43-96 96c0 4 .2 8 .7 11.9l-94.1 47C145.4 170.2 121.9 160 96 160c-53 0-96 43-96 96s43 96 96 96c25.9 0 49.4-10.2 66.6-26.9l94.1 47c-.5 3.9-.7 7.8-.7 11.9c0 53 43 96 96 96s96-43 96-96s-43-96-96-96c-25.9 0-49.4 10.2-66.6 26.9l-94.1-47c.5-3.9 .7-7.8 .7-11.9s-.2-8-.7-11.9l94.1-47C302.6 213.8 326.1 224 352 224z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"R\u00e9seaux sociaux\" aria-errormessage=\"wpforms-12583-field_23_3-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">R\u00e9seaux sociaux<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M96 96c0-35.3 28.7-64 64-64H448c35.3 0 64 28.7 64 64V416c0 35.3-28.7 64-64 64H80c-44.2 0-80-35.8-80-80V128c0-17.7 14.3-32 32-32s32 14.3 32 32V400c0 8.8 7.2 16 16 16s16-7.2 16-16V96zm64 24v80c0 13.3 10.7 24 24 24H296c13.3 0 24-10.7 24-24V120c0-13.3-10.7-24-24-24H184c-13.3 0-24 10.7-24 24zm208-8c0 8.8 7.2 16 16 16h48c8.8 0 16-7.2 16-16s-7.2-16-16-16H384c-8.8 0-16 7.2-16 16zm0 96c0 8.8 7.2 16 16 16h48c8.8 0 16-7.2 16-16s-7.2-16-16-16H384c-8.8 0-16 7.2-16 16zM160 304c0 8.8 7.2 16 16 16H432c8.8 0 16-7.2 16-16s-7.2-16-16-16H176c-8.8 0-16 7.2-16 16zm0 96c0 8.8 7.2 16 16 16H432c8.8 0 16-7.2 16-16s-7.2-16-16-16H176c-8.8 0-16 7.2-16 16z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"Article\/Blog\" aria-errormessage=\"wpforms-12583-field_23_4-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Article\/Blog<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M128 0c17.7 0 32 14.3 32 32V64H288V32c0-17.7 14.3-32 32-32s32 14.3 32 32V64h48c26.5 0 48 21.5 48 48v48H0V112C0 85.5 21.5 64 48 64H96V32c0-17.7 14.3-32 32-32zM0 192H448V464c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V192zM329 305c9.4-9.4 9.4-24.6 0-33.9s-24.6-9.4-33.9 0l-95 95-47-47c-9.4-9.4-24.6-9.4-33.9 0s-9.4 24.6 0 33.9l64 64c9.4 9.4 24.6 9.4 33.9 0L329 305z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_5\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"\u00c9v\u00e9nement professionnel\" aria-errormessage=\"wpforms-12583-field_23_5-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">\u00c9v\u00e9nement professionnel<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-6 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_6\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M184 48H328c4.4 0 8 3.6 8 8V96H176V56c0-4.4 3.6-8 8-8zm-56 8V96H64C28.7 96 0 124.7 0 160v96H192 320 512V160c0-35.3-28.7-64-64-64H384V56c0-30.9-25.1-56-56-56H184c-30.9 0-56 25.1-56 56zM512 288H320v32c0 17.7-14.3 32-32 32H224c-17.7 0-32-14.3-32-32V288H0V416c0 35.3 28.7 64 64 64H448c35.3 0 64-28.7 64-64V288z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_6\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"Prospection commerciale\" aria-errormessage=\"wpforms-12583-field_23_6-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Prospection commerciale<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-7 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_23_7\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 448 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M8 256a56 56 0 1 1 112 0A56 56 0 1 1 8 256zm160 0a56 56 0 1 1 112 0 56 56 0 1 1 -112 0zm216-56a56 56 0 1 1 0 112 56 56 0 1 1 0-112z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-12583-field_23_7\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][23]\" value=\"Autre\" aria-errormessage=\"wpforms-12583-field_23_7-error\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Autre<\/span>\n\t\t\t<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-12583-field_24-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"24\"><fieldset><legend class=\"wpforms-field-label\">Services attendus de notre partenariat <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-12583-field_24\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-modern wpforms-icon-choices-small\" style=\"--wpforms-icon-choices-color: #369f97;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M64 64c0-17.7-14.3-32-32-32S0 46.3 0 64V400c0 44.2 35.8 80 80 80H480c17.7 0 32-14.3 32-32s-14.3-32-32-32H80c-8.8 0-16-7.2-16-16V64zm406.6 86.6c12.5-12.5 12.5-32.8 0-45.3s-32.8-12.5-45.3 0L320 210.7l-57.4-57.4c-12.5-12.5-32.8-12.5-45.3 0l-112 112c-12.5 12.5-12.5 32.8 0 45.3s32.8 12.5 45.3 0L240 221.3l57.4 57.4c12.5 12.5 32.8 12.5 45.3 0l128-128z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Augmentation de la visibilit\u00e9\" aria-errormessage=\"wpforms-12583-field_24_1-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Augmentation de la visibilit\u00e9<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M448 256A192 192 0 1 0 64 256a192 192 0 1 0 384 0zM0 256a256 256 0 1 1 512 0A256 256 0 1 1 0 256zm256 80a80 80 0 1 0 0-160 80 80 0 1 0 0 160zm0-224a144 144 0 1 1 0 288 144 144 0 1 1 0-288zM224 256a32 32 0 1 1 64 0 32 32 0 1 1 -64 0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_2\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Apport de clients qualifi\u00e9s\" aria-errormessage=\"wpforms-12583-field_24_2-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Apport de clients qualifi\u00e9s<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-3 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_3\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M384 96V320H64L64 96H384zM64 32C28.7 32 0 60.7 0 96V320c0 35.3 28.7 64 64 64H181.3l-10.7 32H96c-17.7 0-32 14.3-32 32s14.3 32 32 32H352c17.7 0 32-14.3 32-32s-14.3-32-32-32H277.3l-10.7-32H384c35.3 0 64-28.7 64-64V96c0-35.3-28.7-64-64-64H64zm464 0c-26.5 0-48 21.5-48 48V432c0 26.5 21.5 48 48 48h64c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48H528zm16 64h32c8.8 0 16 7.2 16 16s-7.2 16-16 16H544c-8.8 0-16-7.2-16-16s7.2-16 16-16zm-16 80c0-8.8 7.2-16 16-16h32c8.8 0 16 7.2 16 16s-7.2 16-16 16H544c-8.8 0-16-7.2-16-16zm32 160a32 32 0 1 1 0 64 32 32 0 1 1 0-64z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Pr\u00e9sence sur votre plateforme\" aria-errormessage=\"wpforms-12583-field_24_3-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Pr\u00e9sence sur votre plateforme<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 640 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M323.4 85.2l-96.8 78.4c-16.1 13-19.2 36.4-7 53.1c12.9 17.8 38 21.3 55.3 7.8l99.3-77.2c7-5.4 17-4.2 22.5 2.8s4.2 17-2.8 22.5l-20.9 16.2L512 316.8V128h-.7l-3.9-2.5L434.8 79c-15.3-9.8-33.2-15-51.4-15c-21.8 0-43 7.5-60 21.2zm22.8 124.4l-51.7 40.2C263 274.4 217.3 268 193.7 235.6c-22.2-30.5-16.6-73.1 12.7-96.8l83.2-67.3c-11.6-4.9-24.1-7.4-36.8-7.4C234 64 215.7 69.6 200 80l-72 48V352h28.2l91.4 83.4c19.6 17.9 49.9 16.5 67.8-3.1c5.5-6.1 9.2-13.2 11.1-20.6l17 15.6c19.5 17.9 49.9 16.6 67.8-2.9c4.5-4.9 7.8-10.6 9.9-16.5c19.4 13 45.8 10.3 62.1-7.5c17.9-19.5 16.6-49.9-2.9-67.8l-134.2-123zM16 128c-8.8 0-16 7.2-16 16V352c0 17.7 14.3 32 32 32H64c17.7 0 32-14.3 32-32V128H16zM48 320a16 16 0 1 1 0 32 16 16 0 1 1 0-32zM544 128V352c0 17.7 14.3 32 32 32h32c17.7 0 32-14.3 32-32V144c0-8.8-7.2-16-16-16H544zm32 208a16 16 0 1 1 32 0 16 16 0 1 1 -32 0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Recommandations crois\u00e9es\" aria-errormessage=\"wpforms-12583-field_24_4-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Recommandations crois\u00e9es<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-5 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_5\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M255.4 48.2c.2-.1 .4-.2 .6-.2s.4 .1 .6 .2L460.6 194c2.1 1.5 3.4 3.9 3.4 6.5v13.6L291.5 355.7c-20.7 17-50.4 17-71.1 0L48 214.1V200.5c0-2.6 1.2-5 3.4-6.5L255.4 48.2zM48 276.2L190 392.8c38.4 31.5 93.7 31.5 132 0L464 276.2V456c0 4.4-3.6 8-8 8H56c-4.4 0-8-3.6-8-8V276.2zM256 0c-10.2 0-20.2 3.2-28.5 9.1L23.5 154.9C8.7 165.4 0 182.4 0 200.5V456c0 30.9 25.1 56 56 56H456c30.9 0 56-25.1 56-56V200.5c0-18.1-8.7-35.1-23.4-45.6L284.5 9.1C276.2 3.2 266.2 0 256 0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_5\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Support marketing\" aria-errormessage=\"wpforms-12583-field_24_5-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Support marketing<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-6 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_6\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 512 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M128 32V64H80c-26.5 0-48 21.5-48 48v48H480V112c0-26.5-21.5-48-48-48H384V32c0-17.7-14.3-32-32-32s-32 14.3-32 32V64H192V32c0-17.7-14.3-32-32-32s-32 14.3-32 32zM480 192H32V464c0 26.5 21.5 48 48 48H432c26.5 0 48-21.5 48-48V192zM256 248c13.3 0 24 10.7 24 24v56h56c13.3 0 24 10.7 24 24s-10.7 24-24 24H280v56c0 13.3-10.7 24-24 24s-24-10.7-24-24V376H176c-13.3 0-24-10.7-24-24s10.7-24 24-24h56V272c0-13.3 10.7-24 24-24z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_6\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Participation \u00e0 des \u00e9v\u00e9nements\" aria-errormessage=\"wpforms-12583-field_24_6-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Participation \u00e0 des \u00e9v\u00e9nements<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-7 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_24_7\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"32px\" viewBox=\"0 0 384 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M272 384c9.6-31.9 29.5-59.1 49.2-86.2l0 0c5.2-7.1 10.4-14.2 15.4-21.4c19.8-28.5 31.4-63 31.4-100.3C368 78.8 289.2 0 192 0S16 78.8 16 176c0 37.3 11.6 71.9 31.4 100.3c5 7.2 10.2 14.3 15.4 21.4l0 0c19.8 27.1 39.7 54.4 49.2 86.2H272zM192 512c44.2 0 80-35.8 80-80V416H112v16c0 44.2 35.8 80 80 80zM112 176c0 8.8-7.2 16-16 16s-16-7.2-16-16c0-61.9 50.1-112 112-112c8.8 0 16 7.2 16 16s-7.2 16-16 16c-44.2 0-80 35.8-80 80z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-12583-field_24_7\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][24][]\" value=\"Conseils business\" aria-errormessage=\"wpforms-12583-field_24_7-error\" aria-describedby=\"wpforms-12583-field_24-description\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Conseils business<\/span>\n\t\t\t<\/label><\/li><\/ul><div id=\"wpforms-12583-field_24-description\" class=\"wpforms-field-description\">Qu'attendez-vous de notre collaboration ? (plusieurs choix possibles)<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_25-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"25\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"4\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Pr\u00e9c\u00e9dent<\/button><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"4\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Suivant<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-5  \" data-page=\"5\" style=\"display:none;\"><div id=\"wpforms-12583-field_26-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"26\"><fieldset><legend class=\"wpforms-field-label wpforms-label-hide\" aria-hidden=\"false\">Nom du contact principal <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-12583-field_26\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][26][first]\" placeholder=\"Pr\u00e9nom*\" aria-errormessage=\"wpforms-12583-field_26-error\" aria-describedby=\"wpforms-12583-field_26-description\" required><label for=\"wpforms-12583-field_26\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-12583-field_26-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][26][last]\" placeholder=\"Nom*\" aria-errormessage=\"wpforms-12583-field_26-last-error\" aria-describedby=\"wpforms-12583-field_26-description\" required><label for=\"wpforms-12583-field_26-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><div id=\"wpforms-12583-field_26-description\" class=\"wpforms-field-description\">Personne responsable du partenariat<\/div><\/fieldset><\/div><div id=\"wpforms-12583-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_27\">Fonction\/Poste <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-12583-field_27\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][27]\" placeholder=\"Votre fonction dans l&#039;entreprise\" aria-errormessage=\"wpforms-12583-field_27-error\" aria-describedby=\"wpforms-12583-field_27-description\" required><div id=\"wpforms-12583-field_27-description\" class=\"wpforms-field-description\">Ex: Directeur, G\u00e9rant, Responsable commercial...<\/div><\/div><div id=\"wpforms-12583-field_28-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_28\">T\u00e9l\u00e9phone professionnel <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-12583-field_28\" class=\"wpforms-field-large wpforms-field-required\" data-rule-int-phone-field=\"true\" name=\"wpforms[fields][28]\" value=\"+32\" placeholder=\"T\u00e9l\u00e9phone*\" aria-label=\"T\u00e9l\u00e9phone professionnel\" aria-errormessage=\"wpforms-12583-field_28-error\" required><\/div><div id=\"wpforms-12583-field_29-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_29\">E-mail professionnel <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-12583-field_29\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][29]\" placeholder=\"E-mail*\" spellcheck=\"false\" aria-errormessage=\"wpforms-12583-field_29-error\" required><\/div><div id=\"wpforms-12583-field_30-container\" class=\"wpforms-field wpforms-field-url\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_30\">Site web<\/label><input type=\"url\" id=\"wpforms-12583-field_30\" class=\"wpforms-field-large\" name=\"wpforms[fields][30]\" placeholder=\"https:\/\/www.votre-site.be\" aria-errormessage=\"wpforms-12583-field_30-error\" aria-describedby=\"wpforms-12583-field_30-description\" ><div id=\"wpforms-12583-field_30-description\" class=\"wpforms-field-description\">Si vous en avez un<\/div><\/div><div id=\"wpforms-12583-field_31-container\" class=\"wpforms-field wpforms-field-url\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_31\">Facebook<\/label><input type=\"url\" id=\"wpforms-12583-field_31\" class=\"wpforms-field-large\" name=\"wpforms[fields][31]\" placeholder=\"https:\/\/facebook.com\/votre-page\" aria-errormessage=\"wpforms-12583-field_31-error\" ><\/div>\t\t<div id=\"wpforms-12583-field_41-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"41\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-12583-field_41\" >d\u00e9placement E-mail professionnel<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-12583-field_41\" class=\"wpforms-field-medium\" name=\"wpforms[fields][41]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-12583-field_32-container\" class=\"wpforms-field wpforms-field-url\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_32\">Instagram<\/label><input type=\"url\" id=\"wpforms-12583-field_32\" class=\"wpforms-field-large\" name=\"wpforms[fields][32]\" placeholder=\"https:\/\/instagram.com\/votre-compte\" aria-errormessage=\"wpforms-12583-field_32-error\" ><\/div><div 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60.9 342.6 73.4L438.6 169.4C451.1 181.9 451.1 202.2 438.6 214.7C426.1 227.2 405.8 227.2 393.3 214.7L352 173.3zM320 464C364.2 464 400 428.2 400 384L480 384C515.3 384 544 412.7 544 448L544 480C544 515.3 515.3 544 480 544L160 544C124.7 544 96 515.3 96 480L96 448C96 412.7 124.7 384 160 384L240 384C240 428.2 275.8 464 320 464zM464 488C477.3 488 488 477.3 488 464C488 450.7 477.3 440 464 440C450.7 440 440 450.7 440 464C440 477.3 450.7 488 464 488z\"\/>\n\t\t<\/svg>\n\n\t\t<span class=\"modern-title\">\n\t\t\t\t\t\t\tDrag &amp; Drop Files, \t\t\t\t<span>Choose Files to Upload<\/span>\n\t\t\t\t\t<\/span>\n\n\t\t\t\t\t<span class=\"modern-hint\">You can upload up to 8 files.<\/span>\n\t\t\t<\/div>\n<\/div>\n\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-12583-field_33\"\n\t\tname=\"wpforms_12583_33\" \t\tvalue=\"\">\n<div id=\"wpforms-12583-field_33-description\" class=\"wpforms-field-description\">Brochures, photos de vos activit\u00e9s, certificats d'assurance... (max 15MB total)<\/div><\/div><div id=\"wpforms-12583-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-12583-field_34\">Message compl\u00e9mentaire<\/label><textarea id=\"wpforms-12583-field_34\" class=\"wpforms-field-medium\" name=\"wpforms[fields][34]\" placeholder=\"Questions, demandes sp\u00e9cifiques, disponibilit\u00e9s...\" aria-errormessage=\"wpforms-12583-field_34-error\" aria-describedby=\"wpforms-12583-field_34-description\" ><\/textarea><div id=\"wpforms-12583-field_34-description\" class=\"wpforms-field-description\">Tout ce que vous souhaitez nous dire d'autre...<\/div><\/div><div id=\"wpforms-12583-field_35-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"35\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"5\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Pr\u00e9c\u00e9dent<\/button><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"5\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Envoyer ma candidature<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-6 last \" data-page=\"6\" style=\"display:none;\"><div id=\"wpforms-12583-field_36-container\" class=\"wpforms-field wpforms-field-entry-preview\" data-field-id=\"36\"><div class=\"wpforms-entry-preview-updating-message\">Updating preview\u2026<\/div><div class=\"wpforms-entry-preview-notice\" style=\"display: none;\"><b>Ceci est un aper\u00e7u de votre candidature.<\/b><br \/>\n<br \/>\n<p>Elle n'a pas encore \u00e9t\u00e9 envoy\u00e9e ! Vous pouvez revenir en arri\u00e8re pour modifier vos informations si n\u00e9cessaire.<\/p><\/div><div class=\"wpforms-entry-preview-wrapper\" style=\"display: none;\"><\/div><\/div><div id=\"wpforms-12583-field_37-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"37\"><\/div><div id=\"wpforms-12583-field_38-container\" class=\"wpforms-field wpforms-field-gdpr-checkbox\" data-field-id=\"38\"><label class=\"wpforms-field-label\">Consentements <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><ul id=\"wpforms-12583-field_38\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-12583-field_38_1\" name=\"wpforms[fields][38][]\" value=\"J&#039;accepte la &lt;a target=&quot;_blank&quot; href=&quot;\/politique-de-confidentialite\/&quot;&gt;politique de confidentialit\u00e9&lt;\/a&gt; et autorise Activit\u00e9s Bruxelles \u00e0 traiter mes donn\u00e9es pour \u00e9valuer ma candidature de partenariat\" aria-errormessage=\"wpforms-12583-field_38_1-error\" aria-describedby=\"wpforms-12583-field_38-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_38_1\">J'accepte la <a target=\"_blank\" href=\"\/politique-de-confidentialite\/\">politique de confidentialit\u00e9<\/a> et autorise Activit\u00e9s Bruxelles \u00e0 traiter mes donn\u00e9es pour \u00e9valuer ma candidature de partenariat<\/label><\/li><\/ul><div id=\"wpforms-12583-field_38-description\" class=\"wpforms-field-description\">Conform\u00e9ment au RGPD, votre consentement est requis<\/div><\/div><div id=\"wpforms-12583-field_39-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"39\"><fieldset><legend class=\"wpforms-field-label\">Autorisations suppl\u00e9mentaires (optionnel)<\/legend><ul id=\"wpforms-12583-field_39\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-12583-field_39_1\" name=\"wpforms[fields][39][]\" value=\"J&#039;autorise Activit\u00e9s Bruxelles \u00e0 utiliser mes informations comme r\u00e9f\u00e9rence commerciale\" aria-errormessage=\"wpforms-12583-field_39_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_39_1\">J'autorise Activit\u00e9s Bruxelles \u00e0 utiliser mes informations comme r\u00e9f\u00e9rence commerciale<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-12583-field_39_2\" name=\"wpforms[fields][39][]\" value=\"Je souhaite \u00eatre inform\u00e9 des opportunit\u00e9s business du r\u00e9seau\" aria-errormessage=\"wpforms-12583-field_39_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-12583-field_39_2\">Je souhaite \u00eatre inform\u00e9 des opportunit\u00e9s business du r\u00e9seau<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-12583-field_40-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"40\"><div class=\"wpforms-clear wpforms-pagebreak-split\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"6\" data-formid=\"12583\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Pr\u00e9c\u00e9dent<\/button><\/div><\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-12583-field_41-container { position: absolute !important; 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Rejoignez nos 30+ partenaires et boostez votre visibilit\u00e9 ! Remplissez ce formulaire en 5 minutes, notre \u00e9quipe partenariats vous recontacte sous 48h pour \u00e9tudier les opportunit\u00e9s de collaboration. D\u00e9veloppez votre client\u00e8le B\u00e9n\u00e9ficiez de notre r\u00e9seau Support marketing inclus Please enable JavaScript [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":95,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_breakdance_hide_in_design_set":false,"_breakdance_tags":"","footnotes":""},"class_list":["post-10814","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/pages\/10814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/comments?post=10814"}],"version-history":[{"count":0,"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/pages\/10814\/revisions"}],"wp:attachment":[{"href":"https:\/\/activitesbruxelles.be\/en\/wp-json\/wp\/v2\/media?parent=10814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}