{"id":265,"date":"2026-07-15T12:04:50","date_gmt":"2026-07-15T10:04:50","guid":{"rendered":"https:\/\/new.rallyvanzuidlimburg.be\/?post_type=sureforms_form&#038;p=265"},"modified":"2026-08-07T12:26:56","modified_gmt":"2026-08-07T10:26:56","slug":"inschrijving-10e-regularity-van-zuid-limburg-2026","status":"publish","type":"sureforms_form","link":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/form\/inschrijving-10e-regularity-van-zuid-limburg-2026\/","title":{"rendered":"Inscription 10e Regularity van Zuid-Limburg 2026"},"content":{"rendered":"<div data-block-id=\"ad4dbd77\" class=\"wp-block-uagb-advanced-heading uagb-block uagb-block-ad4dbd77 265\" >\n\t\t\t\t\t<h2 class=\"uagb-heading-text\">Pilote &amp; Copilote<\/h2>\t\t\t\t<\/div>\n\t\t\t\n\n\t\t\t<div data-block-id=\"46f1f5fb\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-46f1f5fb-block  srfm-block-width-50 srfm-slug-pnaam 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-46f1f5fb-lbl-TmFhbSBQaWxvb3Q\" for=\"srfm-input-46f1f5fb-lbl-TmFhbSBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tNom Pilote\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-46f1f5fb-lbl-TmFhbSBQaWxvb3Q-pnaam\" id=\"srfm-input-46f1f5fb-lbl-TmFhbSBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-46f1f5fb'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-46f1f5fb\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"047efd09\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-047efd09-block  srfm-block-width-50 srfm-slug-cnaam 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-047efd09-lbl-TmFhbSBDb3BpbG9vdA\" for=\"srfm-input-047efd09-lbl-TmFhbSBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tNom copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-047efd09-lbl-TmFhbSBDb3BpbG9vdA-cnaam\" id=\"srfm-input-047efd09-lbl-TmFhbSBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-047efd09'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-047efd09\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"7338c5c2\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-7338c5c2-block  srfm-block-width-50 srfm-slug-pvoornaam 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-7338c5c2-lbl-Vm9vcm5hYW0gUGlsb290\" for=\"srfm-input-7338c5c2-lbl-Vm9vcm5hYW0gUGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPr\u00e9nom Pilote\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-7338c5c2-lbl-Vm9vcm5hYW0gUGlsb290-pvoornaam\" id=\"srfm-input-7338c5c2-lbl-Vm9vcm5hYW0gUGlsb290\"\n\t\t\t\t\taria-describedby='srfm-error-7338c5c2'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-7338c5c2\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"260b643a\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-260b643a-block  srfm-block-width-50 srfm-slug-cvoornaam 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-260b643a-lbl-Vm9vcm5hYW0gQ29waWxvb3Q\" for=\"srfm-input-260b643a-lbl-Vm9vcm5hYW0gQ29waWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPr\u00e9nom Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-260b643a-lbl-Vm9vcm5hYW0gQ29waWxvb3Q-cvoornaam\" id=\"srfm-input-260b643a-lbl-Vm9vcm5hYW0gQ29waWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-260b643a'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-260b643a\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"383e6ab8\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-383e6ab8-block  srfm-block-width-50 srfm-slug-pgeboortedatum 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-383e6ab8-lbl-R2Vib29ydGVkYXR1bSBQaWxvb3Q\" for=\"srfm-input-383e6ab8-lbl-R2Vib29ydGVkYXR1bSBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tDate de naissance Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-383e6ab8-lbl-R2Vib29ydGVkYXR1bSBQaWxvb3Q-pgeboortedatum\" id=\"srfm-input-383e6ab8-lbl-R2Vib29ydGVkYXR1bSBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-383e6ab8'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-383e6ab8\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"65aeff3c\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-65aeff3c-block  srfm-block-width-50 srfm-slug-cgeboortedatum 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-65aeff3c-lbl-R2Vib29ydGVkYXR1bSBDb3BpbG9vdA\" for=\"srfm-input-65aeff3c-lbl-R2Vib29ydGVkYXR1bSBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tDate de naissance Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-65aeff3c-lbl-R2Vib29ydGVkYXR1bSBDb3BpbG9vdA-cgeboortedatum\" id=\"srfm-input-65aeff3c-lbl-R2Vib29ydGVkYXR1bSBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-65aeff3c'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-65aeff3c\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"bdf32199\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-bdf32199-block  srfm-block-width-50 srfm-slug-pnationaliteit 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-bdf32199-lbl-TmF0aW9uYWxpdGVpdCBQaWxvb3Q\" for=\"srfm-input-bdf32199-lbl-TmF0aW9uYWxpdGVpdCBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tNationalit\u00e9 Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-bdf32199-lbl-TmF0aW9uYWxpdGVpdCBQaWxvb3Q-pnationaliteit\" id=\"srfm-input-bdf32199-lbl-TmF0aW9uYWxpdGVpdCBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-bdf32199'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-bdf32199\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"10e2632b\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-10e2632b-block  srfm-block-width-50 srfm-slug-cnationaliteit 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-10e2632b-lbl-TmF0aW9uYWxpdGVpdCBDb3BpbG9vdA\" for=\"srfm-input-10e2632b-lbl-TmF0aW9uYWxpdGVpdCBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tNationalit\u00e9 Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-10e2632b-lbl-TmF0aW9uYWxpdGVpdCBDb3BpbG9vdA-cnationaliteit\" id=\"srfm-input-10e2632b-lbl-TmF0aW9uYWxpdGVpdCBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-10e2632b'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-10e2632b\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"f2b4155c\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-f2b4155c-block  srfm-block-width-50 srfm-slug-padres1 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-f2b4155c-lbl-U3RyYWF0ICsgTnIgUGlsb290\" for=\"srfm-input-f2b4155c-lbl-U3RyYWF0ICsgTnIgUGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tRue + N\u00b0 Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-f2b4155c-lbl-U3RyYWF0ICsgTnIgUGlsb290-padres1\" id=\"srfm-input-f2b4155c-lbl-U3RyYWF0ICsgTnIgUGlsb290\"\n\t\t\t\t\taria-describedby='srfm-error-f2b4155c'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-f2b4155c\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"21a4b859\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-21a4b859-block  srfm-block-width-50 srfm-slug-cadres1 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-21a4b859-lbl-U3RyYWF0ICsgTnIgQ29waWxvb3Q\" for=\"srfm-input-21a4b859-lbl-U3RyYWF0ICsgTnIgQ29waWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tRue + N\u00b0 Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-21a4b859-lbl-U3RyYWF0ICsgTnIgQ29waWxvb3Q-cadres1\" id=\"srfm-input-21a4b859-lbl-U3RyYWF0ICsgTnIgQ29waWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-21a4b859'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-21a4b859\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"8f9ffa0e\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-8f9ffa0e-block  srfm-block-width-50 srfm-slug-padres2 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-8f9ffa0e-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBQaWxvb3Q\" for=\"srfm-input-8f9ffa0e-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCode postal + Commune Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-8f9ffa0e-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBQaWxvb3Q-padres2\" id=\"srfm-input-8f9ffa0e-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-8f9ffa0e'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-8f9ffa0e\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"82610014\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-82610014-block  srfm-block-width-50 srfm-slug-cadres2 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-82610014-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBDb3BpbG9vdA\" for=\"srfm-input-82610014-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCode postal + Commune Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-82610014-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBDb3BpbG9vdA-cadres2\" id=\"srfm-input-82610014-lbl-UG9zdGNvZGUgKyBHZW1lZW50ZSBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-82610014'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-82610014\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"c6cf4ddb\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-c6cf4ddb-block  srfm-block-width-50 srfm-slug-pidentiteitskaart 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-c6cf4ddb-lbl-SWRlbnRpdGVpdHNrYWFydCBQaWxvb3Q\" for=\"srfm-input-c6cf4ddb-lbl-SWRlbnRpdGVpdHNrYWFydCBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCarte d'identit\u00e9 Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-c6cf4ddb-lbl-SWRlbnRpdGVpdHNrYWFydCBQaWxvb3Q-pidentiteitskaart\" id=\"srfm-input-c6cf4ddb-lbl-SWRlbnRpdGVpdHNrYWFydCBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-c6cf4ddb'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-c6cf4ddb\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"bac15caf\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-bac15caf-block  srfm-block-width-50 srfm-slug-cidentiteitskaart 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-bac15caf-lbl-SWRlbnRpdGVpdHNrYWFydCBDb3BpbG9vdA\" for=\"srfm-input-bac15caf-lbl-SWRlbnRpdGVpdHNrYWFydCBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCarte d'identit\u00e9 Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-bac15caf-lbl-SWRlbnRpdGVpdHNrYWFydCBDb3BpbG9vdA-cidentiteitskaart\" id=\"srfm-input-bac15caf-lbl-SWRlbnRpdGVpdHNrYWFydCBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-bac15caf'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-bac15caf\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"8d260431\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-8d260431-block  srfm-block-width-50 srfm-slug-ptelgsm 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-8d260431-lbl-R1NNIFBpbG9vdA\" for=\"srfm-input-8d260431-lbl-R1NNIFBpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tGSM Pilote\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-8d260431-lbl-R1NNIFBpbG9vdA-ptelgsm\" id=\"srfm-input-8d260431-lbl-R1NNIFBpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-8d260431'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-8d260431\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"e8c85cc9\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-e8c85cc9-block  srfm-block-width-50 srfm-slug-ctelgsm 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-e8c85cc9-lbl-R1NNIENvcGlsb290\" for=\"srfm-input-e8c85cc9-lbl-R1NNIENvcGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tGSM Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-e8c85cc9-lbl-R1NNIENvcGlsb290-ctelgsm\" id=\"srfm-input-e8c85cc9-lbl-R1NNIENvcGlsb290\"\n\t\t\t\t\taria-describedby='srfm-error-e8c85cc9'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-e8c85cc9\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"70317410\" class=\"srfm-block-single srfm-block srfm-email-block srf-email-70317410-block  srfm-block-width-50 srfm-slug-pemail 265 srfm-email-block-wrap\">\n\t\t\t\t<div class=\"srfm-email-block srf-email-70317410-block\">\n\t\t\t\t\t\t\t\t\t\t<label id=\"srfm-label-70317410-lbl-RW1haWwgUGlsb290\" for=\"srfm-email-70317410-lbl-RW1haWwgUGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tEmail Pilote\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t\t\t<input class=\"srfm-input-common srfm-input-email\" type=\"email\" name=\"srfm-email-70317410-lbl-RW1haWwgUGlsb290-pemail\" id=\"srfm-email-70317410-lbl-RW1haWwgUGlsb290\"\n\t\t\t\t\t\taria-describedby='srfm-error-70317410'\t\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" value=\"\"   \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-70317410\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"afbb4d6e\" class=\"srfm-block-single srfm-block srfm-email-block srf-email-afbb4d6e-block  srfm-block-width-50 srfm-slug-cemail 265 srfm-email-block-wrap\">\n\t\t\t\t<div class=\"srfm-email-block srf-email-afbb4d6e-block\">\n\t\t\t\t\t\t\t\t\t\t<label id=\"srfm-label-afbb4d6e-lbl-RW1haWwgQ29waWxvb3Q\" for=\"srfm-email-afbb4d6e-lbl-RW1haWwgQ29waWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tEmail Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t\t\t<input class=\"srfm-input-common srfm-input-email\" type=\"email\" name=\"srfm-email-afbb4d6e-lbl-RW1haWwgQ29waWxvb3Q-cemail\" id=\"srfm-email-afbb4d6e-lbl-RW1haWwgQ29waWxvb3Q\"\n\t\t\t\t\t\taria-describedby='srfm-error-afbb4d6e'\t\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" value=\"\"   \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-afbb4d6e\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"0ea14cdd\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-0ea14cdd-block  srfm-block-width-50 srfm-slug-pvergunning 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-0ea14cdd-lbl-VmVyZ3VubmluZyBQaWxvb3Q\" for=\"srfm-input-0ea14cdd-lbl-VmVyZ3VubmluZyBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tLicence Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-0ea14cdd-lbl-VmVyZ3VubmluZyBQaWxvb3Q-pvergunning\" id=\"srfm-input-0ea14cdd-lbl-VmVyZ3VubmluZyBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-0ea14cdd'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-0ea14cdd\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"a679b18d\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-a679b18d-block  srfm-block-width-50 srfm-slug-cvergunning 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-a679b18d-lbl-VmVyZ3VubmluZyBDb3BpbG9vdA\" for=\"srfm-input-a679b18d-lbl-VmVyZ3VubmluZyBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tLicence Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-a679b18d-lbl-VmVyZ3VubmluZyBDb3BpbG9vdA-cvergunning\" id=\"srfm-input-a679b18d-lbl-VmVyZ3VubmluZyBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-a679b18d'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-a679b18d\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"9f266e9f\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-9f266e9f-block  srfm-block-width-50 srfm-slug-prijbewijs 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-9f266e9f-lbl-UmlqYmV3aWpzIFBpbG9vdA\" for=\"srfm-input-9f266e9f-lbl-UmlqYmV3aWpzIFBpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPermis de conduire Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-9f266e9f-lbl-UmlqYmV3aWpzIFBpbG9vdA-prijbewijs\" id=\"srfm-input-9f266e9f-lbl-UmlqYmV3aWpzIFBpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-9f266e9f'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-9f266e9f\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"92babea7\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-92babea7-block  srfm-block-width-50 srfm-slug-crijbewijs 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-92babea7-lbl-UmlqYmV3aWpzIENvcGlsb290\" for=\"srfm-input-92babea7-lbl-UmlqYmV3aWpzIENvcGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPermis de conduire Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-92babea7-lbl-UmlqYmV3aWpzIENvcGlsb290-crijbewijs\" id=\"srfm-input-92babea7-lbl-UmlqYmV3aWpzIENvcGlsb290\"\n\t\t\t\t\taria-describedby='srfm-error-92babea7'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-92babea7\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"5f406df4\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-5f406df4-block  srfm-block-width-50 srfm-slug-pafgegeveninland 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-5f406df4-lbl-QWZnZWdldmVuIGluIGxhbmQgUGlsb290\" for=\"srfm-input-5f406df4-lbl-QWZnZWdldmVuIGluIGxhbmQgUGlsb290\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPays de d\u00e9livrance Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-5f406df4-lbl-QWZnZWdldmVuIGluIGxhbmQgUGlsb290-pafgegeveninland\" id=\"srfm-input-5f406df4-lbl-QWZnZWdldmVuIGluIGxhbmQgUGlsb290\"\n\t\t\t\t\taria-describedby='srfm-error-5f406df4'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-5f406df4\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"cc6eb867\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-cc6eb867-block  srfm-block-width-50 srfm-slug-cafgegeveninland 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-cc6eb867-lbl-QWZnZWdldmVuIGluIGxhbmQgQ29waWxvb3Q\" for=\"srfm-input-cc6eb867-lbl-QWZnZWdldmVuIGluIGxhbmQgQ29waWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPays de d\u00e9livrance Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-cc6eb867-lbl-QWZnZWdldmVuIGluIGxhbmQgQ29waWxvb3Q-cafgegeveninland\" id=\"srfm-input-cc6eb867-lbl-QWZnZWdldmVuIGluIGxhbmQgQ29waWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-cc6eb867'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-cc6eb867\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"481228d0\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-481228d0-block  srfm-block-width-50 srfm-slug-prenstal 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-481228d0-lbl-UmVuc3RhbCBQaWxvb3Q\" for=\"srfm-input-481228d0-lbl-UmVuc3RhbCBQaWxvb3Q\" class=\"srfm-block-label\">\n\t\t\t\t\t\t\u00c9curie Pilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-481228d0-lbl-UmVuc3RhbCBQaWxvb3Q-prenstal\" id=\"srfm-input-481228d0-lbl-UmVuc3RhbCBQaWxvb3Q\"\n\t\t\t\t\taria-describedby='srfm-error-481228d0'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-481228d0\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"1a267466\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-1a267466-block  srfm-block-width-50 srfm-slug-crenstal 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-1a267466-lbl-UmVuc3RhbCBDb3BpbG9vdA\" for=\"srfm-input-1a267466-lbl-UmVuc3RhbCBDb3BpbG9vdA\" class=\"srfm-block-label\">\n\t\t\t\t\t\t\u00c9curie Copilote\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-1a267466-lbl-UmVuc3RhbCBDb3BpbG9vdA-crenstal\" id=\"srfm-input-1a267466-lbl-UmVuc3RhbCBDb3BpbG9vdA\"\n\t\t\t\t\taria-describedby='srfm-error-1a267466'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-1a267466\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t\t<div data-block-id=\"3bd00e73\" class=\"wp-block-uagb-advanced-heading uagb-block uagb-block-3bd00e73 265\" >\n\t\t\t\t\t<h2 class=\"uagb-heading-text\">V\u00e9hicule<\/h2>\t\t\t\t<\/div>\n\t\t\t\n\n\t\t\t<div data-block-id=\"45e0bca3\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-45e0bca3-block  srfm-block-width-100 srfm-slug-merk 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-45e0bca3-lbl-TWVyaw\" for=\"srfm-input-45e0bca3-lbl-TWVyaw\" class=\"srfm-block-label\">\n\t\t\t\t\t\tMarque\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-45e0bca3-lbl-TWVyaw-merk\" id=\"srfm-input-45e0bca3-lbl-TWVyaw\"\n\t\t\t\t\taria-describedby='srfm-error-45e0bca3'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-45e0bca3\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"beda9000\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-beda9000-block  srfm-block-width-100 srfm-slug-registratienr 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-beda9000-lbl-TnVtbWVycGxhYXQ\" for=\"srfm-input-beda9000-lbl-TnVtbWVycGxhYXQ\" class=\"srfm-block-label\">\n\t\t\t\t\t\tPlaque d'immatriculation\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-beda9000-lbl-TnVtbWVycGxhYXQ-registratienr\" id=\"srfm-input-beda9000-lbl-TnVtbWVycGxhYXQ\"\n\t\t\t\t\taria-describedby='srfm-error-beda9000'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-beda9000\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"642bd847\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-642bd847-block  srfm-block-width-100 srfm-slug-model 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-642bd847-lbl-TW9kZWw\" for=\"srfm-input-642bd847-lbl-TW9kZWw\" class=\"srfm-block-label\">\n\t\t\t\t\t\tMod\u00e8le\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-642bd847-lbl-TW9kZWw-model\" id=\"srfm-input-642bd847-lbl-TW9kZWw\"\n\t\t\t\t\taria-describedby='srfm-error-642bd847'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-642bd847\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"48646dce\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-48646dce-block  srfm-block-width-100 srfm-slug-cc 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-48646dce-lbl-Q0M\" for=\"srfm-input-48646dce-lbl-Q0M\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCylindr\u00e9e (CC)\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-48646dce-lbl-Q0M-cc\" id=\"srfm-input-48646dce-lbl-Q0M\"\n\t\t\t\t\taria-describedby='srfm-error-48646dce'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-48646dce\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"5a469e2f\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-5a469e2f-block  srfm-block-width-100 srfm-slug-bouwjaar 265\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-5a469e2f-lbl-Qm91d2phYXI\" for=\"srfm-input-5a469e2f-lbl-Qm91d2phYXI\" class=\"srfm-block-label\">\n\t\t\t\t\t\tAnn\u00e9e de construction\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-5a469e2f-lbl-Qm91d2phYXI-bouwjaar\" id=\"srfm-input-5a469e2f-lbl-Qm91d2phYXI\"\n\t\t\t\t\taria-describedby='srfm-error-5a469e2f'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-5a469e2f\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t\t<div data-block-id=\"bfcf592e\" class=\"wp-block-uagb-advanced-heading uagb-block uagb-block-bfcf592e 265\" >\n\t\t\t\t\t<h2 class=\"uagb-heading-text\">Engagement<\/h2>\t\t\t\t<\/div>\n\t\t\t\n\n\t\t<div data-block-id=\"e3902b3c\" class=\"srfm-block-single srfm-block srfm-multi-choice-block srf-multi-choice-e3902b3c-block  srfm-block-width-100 srfm-slug-publiinrichters 265 srfm-radio-mode\">\n\t\t\t<fieldset>\n\t\t\t\t<input class=\"srfm-input-multi-choice-hidden\" data-required=\"true\" aria-required=\"true\"  name=\"srfm-input-multi-choice-e3902b3c-lbl-QWFudmFhcmR0IHUgcHVibGljaXRlaXQgYWFuZ2Vib2RlbiBkb29yIGRlIGlucmljaHRlcnM\/-publiinrichters\" type=\"hidden\" value=\"\"\/>\n\t\t\t\t<legend class=\"srfm-block-legend\">\n\t\t\t\t\t\t\t\t\t\tAcceptez-vous la publicit\u00e9 propos\u00e9e par les organisateurs ?\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/legend>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap srfm-choice-width-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-e3902b3c-0\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-e3902b3c\"\t\t\t\t\t\t\t\t\t\taria-describedby=\"srfm-error-e3902b3c\"\t\t\t\t\t\t\t\t\t\taria-required=\"true\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-e3902b3c-0\" data-option-text=\"Ja\">Oui<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width=\"17\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><path d=\"M15.1667 2.6665L8.5 9.33984L6.5 7.33984\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z\" stroke=\"#1E1E1E\" stroke-opacity=\"0.7\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-e3902b3c-1\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-e3902b3c\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-e3902b3c-1\" data-option-text=\"Nee\">Non<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width=\"17\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><path d=\"M15.1667 2.6665L8.5 9.33984L6.5 7.33984\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z\" stroke=\"#1E1E1E\" stroke-opacity=\"0.7\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-wrap\">\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-e3902b3c\" data-error-msg=\"This field is required.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t<\/div>\n\t\t\n\n\t\t\t\t<div data-block-id=\"dd00caa7\" class=\"wp-block-uagb-advanced-heading uagb-block uagb-block-dd00caa7 265\" >\n\t\t\t\t\t<h2 class=\"uagb-heading-text\">Droits d'inscription<\/h2>\t\t\t\t<\/div>\n\t\t\t\n\n\t\t<div data-block-id=\"fa6af5e4\" class=\"srfm-block-single srfm-block srfm-multi-choice-block srf-multi-choice-fa6af5e4-block  srfm-block-width-100 srfm-slug-inschrijvingsrechten 265 srfm-radio-mode\">\n\t\t\t<fieldset>\n\t\t\t\t<input class=\"srfm-input-multi-choice-hidden\" data-required=\"true\" aria-required=\"true\"  name=\"srfm-input-multi-choice-fa6af5e4-lbl-SW5zY2hyaWp2aW5nc3JlY2h0ZW4-inschrijvingsrechten\" type=\"hidden\" value=\"\"\/>\n\t\t\t\t<legend class=\"srfm-block-legend\">\n\t\t\t\t\t\t\t\t\t\tDroits d'inscription\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/legend>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-fa6af5e4\">\n\t\t\t\t\t\tSluitingsdatum: 20\/02\/2026 23u59\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap srfm-choice-width-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-fa6af5e4-0\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-fa6af5e4\"\t\t\t\t\t\t\t\t\t\taria-describedby=\"srfm-error-fa6af5e4 srfm-description-fa6af5e4\"\t\t\t\t\t\t\t\t\t\taria-required=\"true\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-fa6af5e4-0\" data-option-text=\"Met publiciteit - 120,-EUR\">Avec publicit\u00e9 \u2013 120,-EUR<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width=\"17\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><path d=\"M15.1667 2.6665L8.5 9.33984L6.5 7.33984\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z\" stroke=\"#1E1E1E\" stroke-opacity=\"0.7\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-fa6af5e4-1\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-fa6af5e4\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-fa6af5e4-1\" data-option-text=\"Zonder publiciteit - 240,-EUR\">Sans publicit\u00e9 \u2013 240,-EUR<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width=\"17\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><path d=\"M15.1667 2.6665L8.5 9.33984L6.5 7.33984\" stroke=\"#111C44\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z\" stroke=\"#1E1E1E\" stroke-opacity=\"0.7\" stroke-width=\"1.25\" stroke-linecap=\"round\" stroke-linejoin=\"round\" \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-wrap\">\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-fa6af5e4\" data-error-msg=\"This field is required.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t<\/div>","protected":false},"author":1,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_srfm_form_confirmation":[{"id":1,"confirmation_type":"same page","page_url":"","custom_url":"","message":"\t\t<p style=\"text-align: center\"><img src=\"data:image\/svg+xml;base64,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\" alt=\"\" aria-hidden=\"true\" \/><\/p><h2 style=\"text-align: center\">Thank you<\/h2><p style=\"text-align: center\">Your form has been submitted successfully. We&#039;ll review your details and get back to you soon.<\/p>\n\t\t","submission_action":"hide form","enable_query_params":false,"query_params":[]}]},"class_list":["post-265","sureforms_form","type-sureforms_form","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/wp-json\/wp\/v2\/sureforms_form\/265","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/wp-json\/wp\/v2\/sureforms_form"}],"about":[{"href":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/wp-json\/wp\/v2\/types\/sureforms_form"}],"author":[{"embeddable":true,"href":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/wp-json\/wp\/v2\/users\/1"}],"wp:attachment":[{"href":"https:\/\/www.rallyvanzuidlimburg.be\/fr\/wp-json\/wp\/v2\/media?parent=265"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}