Formulaire de pré-inscription en ligne
En remplissant le formulaire, vous soumettez votre demande de berceau à notre service inscriptions qui reviendra vers vous au plus vite pour plus de renseignements sur votre situation afin de rejoindre notre eco-crèche.
Vous pouvez également télécharger la version PDF du formulaire ici.
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"><!-- [et_pb_line_break_holder] --><html xmlns="http://www.w3.org/1999/xhtml" xml:lang="fr" lang="fr"><!-- [et_pb_line_break_holder] --><head><!-- [et_pb_line_break_holder] --><meta http-equiv="Content-Type" content="text/html; charset=UTF-8" /><!-- [et_pb_line_break_holder] --><title>Test</title><!-- [et_pb_line_break_holder] --><style type="text/css" media="screen"><!-- [et_pb_line_break_holder] -->#progress-bg <!-- [et_pb_line_break_holder] -->{ <!-- [et_pb_line_break_holder] --> width:10%; <!-- [et_pb_line_break_holder] --> border:dotted; <!-- [et_pb_line_break_holder] --> color:#000000;<!-- [et_pb_line_break_holder] --> display: none;<!-- [et_pb_line_break_holder] -->} <!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --></head><!-- [et_pb_line_break_holder] --><body><!-- [et_pb_line_break_holder] --><form action="<?php echo htmlspecialchars($_SERVER['PHP_SELF']); ?>" method="post" id="monform"><!-- [et_pb_line_break_holder] --> <p>Couleur : <!-- [et_pb_line_break_holder] --> <input type="radio" name="couleur" id="couleur1" value="noir" /><!-- [et_pb_line_break_holder] --> <label for="couleur1">Noir</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="couleur" id="couleur2" value="blanc" /><!-- [et_pb_line_break_holder] --> <label for="couleur2">Blanc</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="couleur" id="couleur3" value="bleu" /><!-- [et_pb_line_break_holder] --> <label for="couleur3">Bleu</label><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p>Age : <!-- [et_pb_line_break_holder] --> <input type="radio" name="age" id="age1" value="15" /><!-- [et_pb_line_break_holder] --> <label for="age1">15 ans</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="age" id="age2" value="20" /><!-- [et_pb_line_break_holder] --> <label for="age2">20 ans</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="age" id="age3" value="25" /><!-- [et_pb_line_break_holder] --> <label for="age3">25 ans</label><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p>Distance : <!-- [et_pb_line_break_holder] --> <input type="radio" name="distance" id="distance1" value="50" /><!-- [et_pb_line_break_holder] --> <label for="distance1">50 km</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="distance" id="distance2" value="100" /><!-- [et_pb_line_break_holder] --> <label for="distance2">100 km</label><!-- [et_pb_line_break_holder] --> <input type="radio" name="distance" id="distance3" value="150" /><!-- [et_pb_line_break_holder] --> <label for="distance3">150 km</label><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p><!-- [et_pb_line_break_holder] --> <input type="submit" /><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div id="progress-bg"><span id="progress">0%</span></div> <!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><script type="text/javascript"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->// fonction addEvent<!-- [et_pb_line_break_holder] -->function addEvent(oElem, sEvType, fn, bCapture)<!-- [et_pb_line_break_holder] -->{<!-- [et_pb_line_break_holder] --> return oElem.addEventListener?<!-- [et_pb_line_break_holder] --> oElem.addEventListener(sEvType, fn, bCapture):<!-- [et_pb_line_break_holder] --> oElem.attachEvent?<!-- [et_pb_line_break_holder] --> oElem.attachEvent('on' + sEvType, fn):<!-- [et_pb_line_break_holder] --> oElem['on' + sEvType] = fn;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->// fonction progressBar<!-- [et_pb_line_break_holder] -->function progressBar()<!-- [et_pb_line_break_holder] -->{<!-- [et_pb_line_break_holder] --> // si les méthodes du DOM n'existent pas, on sort...<!-- [et_pb_line_break_holder] --> if(!document.getElementById <!-- [et_pb_line_break_holder] --> !document.getElementsByTagName)<!-- [et_pb_line_break_holder] --> {<!-- [et_pb_line_break_holder] --> return;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> // pour chaque INPUT...<!-- [et_pb_line_break_holder] --> var afficherBarre = false;<!-- [et_pb_line_break_holder] --> var lInputs = document.getElementById('monform').getElementsByTagName('input');<!-- [et_pb_line_break_holder] --> for(var bouton = 0; bouton < lInputs.length; bouton++){<!-- [et_pb_line_break_holder] --> var oElement = lInputs[bouton];<!-- [et_pb_line_break_holder] --> // Si bouton radio...<!-- [et_pb_line_break_holder] --> if(oElement.type == 'radio') {<!-- [et_pb_line_break_holder] --> afficherBarre = true;<!-- [et_pb_line_break_holder] --> // on affecte sur le onclick l'appel de 'progression'<!-- [et_pb_line_break_holder] --> addEvent(oElement, 'click', progression, false);<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> // on affiche la barre<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (afficherBarre) {<!-- [et_pb_line_break_holder] --> document.getElementById('progress-bg').style.display = 'block';<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->function progression() <!-- [et_pb_line_break_holder] -->{<!-- [et_pb_line_break_holder] --> var totalBoutons = 0;<!-- [et_pb_line_break_holder] --> var totalBoutonsCoches = 0;<!-- [et_pb_line_break_holder] --> var nameBouton = '';<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> // pour chaque INPUT...<!-- [et_pb_line_break_holder] --> var afficherBarre = false;<!-- [et_pb_line_break_holder] --> var lInputs = document.getElementById('monform').getElementsByTagName('input');<!-- [et_pb_line_break_holder] --> for(var bouton = 0; bouton < lInputs.length; bouton++){<!-- [et_pb_line_break_holder] --> var oElement = lInputs[bouton];<!-- [et_pb_line_break_holder] --> // Si bouton radio...<!-- [et_pb_line_break_holder] --> if(oElement.type == 'radio') {<!-- [et_pb_line_break_holder] --> // on compte le nombre total<!-- [et_pb_line_break_holder] --> if(oElement.name != nameBouton) {<!-- [et_pb_line_break_holder] --> nameBouton = oElement.name;<!-- [et_pb_line_break_holder] --> totalBoutons++;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> // ce bouton est-il coché ?<!-- [et_pb_line_break_holder] --> if(oElement.checked) {<!-- [et_pb_line_break_holder] --> totalBoutonsCoches++;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> var div_width = ((totalBoutonsCoches/totalBoutons) * 100); <!-- [et_pb_line_break_holder] --> document.getElementById('progress-bg').style.width = div_width + '%'; <!-- [et_pb_line_break_holder] --> document.getElementById('progress').innerHTML = Math.floor(div_width) + '%'; <!-- [et_pb_line_break_holder] -->} <!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->// Initialisation sur le onload<!-- [et_pb_line_break_holder] -->addEvent(window, 'load', progressBar, false);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></script><!-- [et_pb_line_break_holder] --></body><!-- [et_pb_line_break_holder] --></html>
Erreur: Super Forms could not find a form with ID: 0
