adherer.gcu.asso.fr
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Submitted URL: http://adherer.gcu.asso.fr/
Effective URL: https://adherer.gcu.asso.fr/adherez-au-gcu/mes-informations
Submission: On March 29 via api from US — Scanned from FR
Effective URL: https://adherer.gcu.asso.fr/adherez-au-gcu/mes-informations
Submission: On March 29 via api from US — Scanned from FR
Form analysis 1 forms found in the DOM
POST
<form class="c-form c-membership-form" method="POST" enctype="multipart/form-data" novalidate="novalidate">
<input type="hidden" name="csrf_token" value="9be62e95b9a07ed8cf89386abb09359fbcfcf462o1711739096">
<input type="hidden" id="current_partner" name="current_partner">
<h2 class="c-page-title c-page-title--secondary"> Je renseigne mes informations </h2>
<p class="c-form__info">
<span class="u-hidden--tablet"> Complétez ce formulaire pour adhérer et faire adhérer votre famille. Chaque membre recevra une carte et pourra camper partout en France. <br>
</span>* renseignements obligatoires
</p>
<p class="c-form__step-title">
<span class="c-form__step-title-number">1/</span> 2 - Mes informations personnelles
</p>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required"> Civilité </span>
<div>
<div class="c-custom-radio">
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="title" required="" title="Veuillez sélectionner une civilité." value="1">
<span class="c-custom-radio__name"> Madame </span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="title" required="" title="Veuillez sélectionner une civilité." value="3">
<span class="c-custom-radio__name"> Monsieur </span>
</label>
</div>
</div>
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Nom</span>
<input type="text" placeholder="Ex. : Dupont" name="lastname" required="" title="Veuillez saisir un nom.">
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Prénom</span>
<input type="text" placeholder="Ex. : Bertrand" name="firstname" required="" title="Veuillez saisir un prénom.">
</div>
<div class="c-form__input-container c-form-parent-birthdate">
<span class="c-form__label c-form__label--required"> Date de naissance </span>
<div class="infobulle">
<button type="button" class="c-btn c-btn--help" aria-label="help"></button>
<span class="c-infobulle"> Vous devez être majeur pour adhérer en tant qu’adhérent principal au GCU. </span>
</div>
<div class="c-date-input">
<input type="text" data-toggle="datepicker-birthdate-majority" placeholder="Ex. : XX/XX/XXXX" class="c-date-input__input" name="birthdate" required="" title="Veuillez saisir une date." data-adult="1">
</div>
<p class="c-form__input-info">Ex: XX/XX/XXXX</p>
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required"> Adresse e-mail </span>
<input type="text" placeholder="Ex. : bertranddupont@gmail.com" id="email" name="email" required="" class="email__input" title="Veuillez saisir une adresse e-mail.">
</div>
<div class="c-form__input-container c-form-country">
<span class="c-form__label c-form__label--required">Pays</span>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="select choices__input" id="country" name="country" required="" title="Veuillez sélectionner un pays." hidden="" tabindex="-1" data-choice="active">
<option value="75"> France </option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__item--selectable" data-item="" data-id="1" data-value="75" data-custom-properties="null" aria-selected="true" data-deletable=""> France <button type="button" class="choices__button"
aria-label="Remove item: '75'" data-button="">Remove item</button></div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="false" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--country-item-choice-1" class="choices__item choices__item--choice choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value="3" data-select-text="" data-choice-selectable=""
aria-selected="true"> Afghanistan </div>
<div id="choices--country-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="247" data-select-text="" data-choice-selectable=""> Afrique du sud </div>
<div id="choices--country-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="6" data-select-text="" data-choice-selectable=""> Albanie </div>
<div id="choices--country-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="62" data-select-text="" data-choice-selectable=""> Algérie </div>
<div id="choices--country-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="57" data-select-text="" data-choice-selectable=""> Allemagne </div>
<div id="choices--country-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="1" data-select-text="" data-choice-selectable=""> Andorre </div>
<div id="choices--country-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="8" data-select-text="" data-choice-selectable=""> Angola </div>
<div id="choices--country-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="5" data-select-text="" data-choice-selectable=""> Anguilla </div>
<div id="choices--country-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="9" data-select-text="" data-choice-selectable=""> Antarctique </div>
<div id="choices--country-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="4" data-select-text="" data-choice-selectable=""> Antigua et Barbuda
</div>
<div id="choices--country-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="192" data-select-text="" data-choice-selectable=""> Arabie Saoudite </div>
<div id="choices--country-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="10" data-select-text="" data-choice-selectable=""> Argentine </div>
<div id="choices--country-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="7" data-select-text="" data-choice-selectable=""> Arménie </div>
<div id="choices--country-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="14" data-select-text="" data-choice-selectable=""> Aruba </div>
<div id="choices--country-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="13" data-select-text="" data-choice-selectable=""> Australie </div>
<div id="choices--country-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="12" data-select-text="" data-choice-selectable=""> Autriche </div>
<div id="choices--country-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="" data-choice-selectable=""> Azerbaïdjan </div>
<div id="choices--country-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="32" data-select-text="" data-choice-selectable=""> Bahamas </div>
<div id="choices--country-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="23" data-select-text="" data-choice-selectable=""> Bahreïn </div>
<div id="choices--country-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="18" data-select-text="" data-choice-selectable=""> Barbade </div>
<div id="choices--country-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="" data-choice-selectable=""> Belgique </div>
<div id="choices--country-item-choice-22" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="22" data-value="19" data-select-text="" data-choice-selectable=""> Bengladesh </div>
<div id="choices--country-item-choice-23" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="23" data-value="27" data-select-text="" data-choice-selectable=""> Bermudes </div>
<div id="choices--country-item-choice-24" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="24" data-value="33" data-select-text="" data-choice-selectable=""> Bhoutan </div>
<div id="choices--country-item-choice-25" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="25" data-value="145" data-select-text="" data-choice-selectable=""> Birmanie </div>
<div id="choices--country-item-choice-26" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="26" data-value="36" data-select-text="" data-choice-selectable=""> Biélorussie </div>
<div id="choices--country-item-choice-27" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="27" data-value="29" data-select-text="" data-choice-selectable=""> Bolivie </div>
<div id="choices--country-item-choice-28" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="28" data-value="30" data-select-text="" data-choice-selectable=""> Bonaire, Saint-Eustache
et Saba </div>
<div id="choices--country-item-choice-29" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="29" data-value="17" data-select-text="" data-choice-selectable=""> Bosnie-Herzégovine
</div>
<div id="choices--country-item-choice-30" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="30" data-value="35" data-select-text="" data-choice-selectable=""> Botswana </div>
<div id="choices--country-item-choice-31" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="31" data-value="28" data-select-text="" data-choice-selectable=""> Brunéi Darussalam
</div>
<div id="choices--country-item-choice-32" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="32" data-value="31" data-select-text="" data-choice-selectable=""> Brésil </div>
<div id="choices--country-item-choice-33" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="33" data-value="22" data-select-text="" data-choice-selectable=""> Bulgarie </div>
<div id="choices--country-item-choice-34" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="34" data-value="21" data-select-text="" data-choice-selectable=""> Burkina Faso </div>
<div id="choices--country-item-choice-35" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="35" data-value="24" data-select-text="" data-choice-selectable=""> Burundi </div>
<div id="choices--country-item-choice-36" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="36" data-value="25" data-select-text="" data-choice-selectable=""> Bénin </div>
<div id="choices--country-item-choice-37" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="37" data-value="116" data-select-text="" data-choice-selectable=""> Cambodge </div>
<div id="choices--country-item-choice-38" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="38" data-value="47" data-select-text="" data-choice-selectable=""> Cameroun </div>
<div id="choices--country-item-choice-39" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="39" data-value="38" data-select-text="" data-choice-selectable=""> Canada </div>
<div id="choices--country-item-choice-40" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="40" data-value="52" data-select-text="" data-choice-selectable=""> Cap-Vert </div>
<div id="choices--country-item-choice-41" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="41" data-value="46" data-select-text="" data-choice-selectable=""> Chili </div>
<div id="choices--country-item-choice-42" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="42" data-value="48" data-select-text="" data-choice-selectable=""> Chine </div>
<div id="choices--country-item-choice-43" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="43" data-value="55" data-select-text="" data-choice-selectable=""> Chypre </div>
<div id="choices--country-item-choice-44" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="44" data-value="49" data-select-text="" data-choice-selectable=""> Colombie </div>
<div id="choices--country-item-choice-45" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="45" data-value="118" data-select-text="" data-choice-selectable=""> Comores </div>
<div id="choices--country-item-choice-46" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="46" data-value="42" data-select-text="" data-choice-selectable=""> Congo </div>
<div id="choices--country-item-choice-47" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="47" data-value="120" data-select-text="" data-choice-selectable=""> Corée du Nord </div>
<div id="choices--country-item-choice-48" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="48" data-value="121" data-select-text="" data-choice-selectable=""> Corée du Sud </div>
<div id="choices--country-item-choice-49" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="49" data-value="50" data-select-text="" data-choice-selectable=""> Costa Rica </div>
<div id="choices--country-item-choice-50" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="50" data-value="97" data-select-text="" data-choice-selectable=""> Croatie </div>
<div id="choices--country-item-choice-51" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="51" data-value="51" data-select-text="" data-choice-selectable=""> Cuba </div>
<div id="choices--country-item-choice-52" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="52" data-value="53" data-select-text="" data-choice-selectable=""> Curaçao </div>
<div id="choices--country-item-choice-53" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="53" data-value="44" data-select-text="" data-choice-selectable=""> Côte d'Ivoire </div>
<div id="choices--country-item-choice-54" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="54" data-value="59" data-select-text="" data-choice-selectable=""> Danemark </div>
<div id="choices--country-item-choice-55" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="55" data-value="58" data-select-text="" data-choice-selectable=""> Djibouti </div>
<div id="choices--country-item-choice-56" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="56" data-value="60" data-select-text="" data-choice-selectable=""> Dominique </div>
<div id="choices--country-item-choice-57" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="57" data-value="68" data-select-text="" data-choice-selectable=""> Espagne </div>
<div id="choices--country-item-choice-58" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="58" data-value="64" data-select-text="" data-choice-selectable=""> Estonie </div>
<div id="choices--country-item-choice-59" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="59" data-value="71" data-select-text="" data-choice-selectable=""> Fiji </div>
<div id="choices--country-item-choice-60" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="60" data-value="70" data-select-text="" data-choice-selectable=""> Finlande </div>
<div id="choices--country-item-choice-61" class="choices__item choices__item--choice is-selected choices__item--selectable" role="option" data-choice="" data-id="61" data-value="75" data-select-text="" data-choice-selectable=""> France
</div>
<div id="choices--country-item-choice-62" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="62" data-value="190" data-select-text="" data-choice-selectable=""> Fédération de Russie
</div>
<div id="choices--country-item-choice-63" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="63" data-value="76" data-select-text="" data-choice-selectable=""> Gabon </div>
<div id="choices--country-item-choice-64" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="64" data-value="84" data-select-text="" data-choice-selectable=""> Gambie </div>
<div id="choices--country-item-choice-65" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="65" data-value="78" data-select-text="" data-choice-selectable=""> Georgie </div>
<div id="choices--country-item-choice-66" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="66" data-value="80" data-select-text="" data-choice-selectable=""> Ghana </div>
<div id="choices--country-item-choice-67" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="67" data-value="81" data-select-text="" data-choice-selectable=""> Gibraltar </div>
<div id="choices--country-item-choice-68" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="68" data-value="77" data-select-text="" data-choice-selectable=""> Grenade </div>
<div id="choices--country-item-choice-69" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="69" data-value="83" data-select-text="" data-choice-selectable=""> Groënland </div>
<div id="choices--country-item-choice-70" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="70" data-value="88" data-select-text="" data-choice-selectable=""> Grèce </div>
<div id="choices--country-item-choice-71" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="71" data-value="86" data-select-text="" data-choice-selectable=""> Guadeloupe </div>
<div id="choices--country-item-choice-72" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="72" data-value="91" data-select-text="" data-choice-selectable=""> Guam </div>
<div id="choices--country-item-choice-73" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="73" data-value="90" data-select-text="" data-choice-selectable=""> Guatemala </div>
<div id="choices--country-item-choice-74" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="74" data-value="82" data-select-text="" data-choice-selectable=""> Guernesey </div>
<div id="choices--country-item-choice-75" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="75" data-value="85" data-select-text="" data-choice-selectable=""> Guinée </div>
<div id="choices--country-item-choice-76" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="76" data-value="87" data-select-text="" data-choice-selectable=""> Guinée Équatoriale
</div>
<div id="choices--country-item-choice-77" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="77" data-value="92" data-select-text="" data-choice-selectable=""> Guinée-Bissau </div>
<div id="choices--country-item-choice-78" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="78" data-value="93" data-select-text="" data-choice-selectable=""> Guyane </div>
<div id="choices--country-item-choice-79" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="79" data-value="79" data-select-text="" data-choice-selectable=""> Guyane française </div>
<div id="choices--country-item-choice-80" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="80" data-value="89" data-select-text="" data-choice-selectable=""> Géorgie du Sud-et-les
Îles Sandwich du Sud </div>
<div id="choices--country-item-choice-81" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="81" data-value="98" data-select-text="" data-choice-selectable=""> Haïti </div>
<div id="choices--country-item-choice-82" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="82" data-value="96" data-select-text="" data-choice-selectable=""> Honduras </div>
<div id="choices--country-item-choice-83" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="83" data-value="94" data-select-text="" data-choice-selectable=""> Hong-Kong </div>
<div id="choices--country-item-choice-84" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="84" data-value="99" data-select-text="" data-choice-selectable=""> Hongrie </div>
<div id="choices--country-item-choice-85" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="85" data-value="15" data-select-text="" data-choice-selectable=""> Iles Åland </div>
<div id="choices--country-item-choice-86" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="86" data-value="104" data-select-text="" data-choice-selectable=""> Inde </div>
<div id="choices--country-item-choice-87" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="87" data-value="100" data-select-text="" data-choice-selectable=""> Indonésie </div>
<div id="choices--country-item-choice-88" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="88" data-value="106" data-select-text="" data-choice-selectable=""> Irak </div>
<div id="choices--country-item-choice-89" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="89" data-value="107" data-select-text="" data-choice-selectable=""> Iran </div>
<div id="choices--country-item-choice-90" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="90" data-value="101" data-select-text="" data-choice-selectable=""> Irlande </div>
<div id="choices--country-item-choice-91" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="91" data-value="108" data-select-text="" data-choice-selectable=""> Islande </div>
<div id="choices--country-item-choice-92" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="92" data-value="102" data-select-text="" data-choice-selectable=""> Israël </div>
<div id="choices--country-item-choice-93" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="93" data-value="109" data-select-text="" data-choice-selectable=""> Italie </div>
<div id="choices--country-item-choice-94" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="94" data-value="111" data-select-text="" data-choice-selectable=""> Jamaïque </div>
<div id="choices--country-item-choice-95" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="95" data-value="113" data-select-text="" data-choice-selectable=""> Japon </div>
<div id="choices--country-item-choice-96" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="96" data-value="110" data-select-text="" data-choice-selectable=""> Jersey </div>
<div id="choices--country-item-choice-97" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="97" data-value="112" data-select-text="" data-choice-selectable=""> Jordanie </div>
<div id="choices--country-item-choice-98" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="98" data-value="124" data-select-text="" data-choice-selectable=""> Kazakhstan </div>
<div id="choices--country-item-choice-99" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="99" data-value="114" data-select-text="" data-choice-selectable=""> Kenya </div>
<div id="choices--country-item-choice-100" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="100" data-value="115" data-select-text="" data-choice-selectable=""> Kirghizistan </div>
<div id="choices--country-item-choice-101" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="101" data-value="117" data-select-text="" data-choice-selectable=""> Kiribati </div>
<div id="choices--country-item-choice-102" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="102" data-value="250" data-select-text="" data-choice-selectable=""> Kosovo </div>
<div id="choices--country-item-choice-103" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="103" data-value="122" data-select-text="" data-choice-selectable=""> Koweït </div>
<div id="choices--country-item-choice-104" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="104" data-value="187" data-select-text="" data-choice-selectable=""> La Réunion </div>
<div id="choices--country-item-choice-105" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="105" data-value="125" data-select-text="" data-choice-selectable=""> Laos </div>
<div id="choices--country-item-choice-106" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="106" data-value="37" data-select-text="" data-choice-selectable=""> Le Belize </div>
<div id="choices--country-item-choice-107" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="107" data-value="131" data-select-text="" data-choice-selectable=""> Lesotho </div>
<div id="choices--country-item-choice-108" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="108" data-value="134" data-select-text="" data-choice-selectable=""> Lettonie </div>
<div id="choices--country-item-choice-109" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="109" data-value="126" data-select-text="" data-choice-selectable=""> Liban </div>
<div id="choices--country-item-choice-110" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="110" data-value="130" data-select-text="" data-choice-selectable=""> Liberia </div>
<div id="choices--country-item-choice-111" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="111" data-value="135" data-select-text="" data-choice-selectable=""> Libye </div>
<div id="choices--country-item-choice-112" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="112" data-value="128" data-select-text="" data-choice-selectable=""> Liechtenstein </div>
<div id="choices--country-item-choice-113" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="113" data-value="132" data-select-text="" data-choice-selectable=""> Lituanie </div>
<div id="choices--country-item-choice-114" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="114" data-value="133" data-select-text="" data-choice-selectable=""> Luxembourg </div>
<div id="choices--country-item-choice-115" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="115" data-value="147" data-select-text="" data-choice-selectable=""> Macao </div>
<div id="choices--country-item-choice-116" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="116" data-value="143" data-select-text="" data-choice-selectable=""> Macédoine, ancienne
république yougoslave </div>
<div id="choices--country-item-choice-117" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="117" data-value="141" data-select-text="" data-choice-selectable=""> Madagascar </div>
<div id="choices--country-item-choice-118" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="118" data-value="157" data-select-text="" data-choice-selectable=""> Malaisie </div>
<div id="choices--country-item-choice-119" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="119" data-value="155" data-select-text="" data-choice-selectable=""> Malawi </div>
<div id="choices--country-item-choice-120" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="120" data-value="154" data-select-text="" data-choice-selectable=""> Maldives </div>
<div id="choices--country-item-choice-121" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="121" data-value="144" data-select-text="" data-choice-selectable=""> Mali </div>
<div id="choices--country-item-choice-122" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="122" data-value="152" data-select-text="" data-choice-selectable=""> Malte </div>
<div id="choices--country-item-choice-123" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="123" data-value="136" data-select-text="" data-choice-selectable=""> Maroc </div>
<div id="choices--country-item-choice-124" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="124" data-value="149" data-select-text="" data-choice-selectable=""> Martinique </div>
<div id="choices--country-item-choice-125" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="125" data-value="153" data-select-text="" data-choice-selectable=""> Maurice </div>
<div id="choices--country-item-choice-126" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="126" data-value="150" data-select-text="" data-choice-selectable=""> Mauritanie </div>
<div id="choices--country-item-choice-127" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="127" data-value="246" data-select-text="" data-choice-selectable=""> Mayotte </div>
<div id="choices--country-item-choice-128" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="128" data-value="156" data-select-text="" data-choice-selectable=""> Mexique </div>
<div id="choices--country-item-choice-129" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="129" data-value="73" data-select-text="" data-choice-selectable=""> Micronésie </div>
<div id="choices--country-item-choice-130" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="130" data-value="138" data-select-text="" data-choice-selectable=""> Moldavie </div>
<div id="choices--country-item-choice-131" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="131" data-value="137" data-select-text="" data-choice-selectable=""> Monaco </div>
<div id="choices--country-item-choice-132" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="132" data-value="146" data-select-text="" data-choice-selectable=""> Mongolie </div>
<div id="choices--country-item-choice-133" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="133" data-value="139" data-select-text="" data-choice-selectable=""> Montenegro </div>
<div id="choices--country-item-choice-134" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="134" data-value="151" data-select-text="" data-choice-selectable=""> Montserrat </div>
<div id="choices--country-item-choice-135" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="135" data-value="158" data-select-text="" data-choice-selectable=""> Mozambique </div>
<div id="choices--country-item-choice-136" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="136" data-value="159" data-select-text="" data-choice-selectable=""> Namibie </div>
<div id="choices--country-item-choice-137" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="137" data-value="168" data-select-text="" data-choice-selectable=""> Nauru </div>
<div id="choices--country-item-choice-138" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="138" data-value="164" data-select-text="" data-choice-selectable=""> Nicaragua </div>
<div id="choices--country-item-choice-139" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="139" data-value="161" data-select-text="" data-choice-selectable=""> Niger </div>
<div id="choices--country-item-choice-140" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="140" data-value="163" data-select-text="" data-choice-selectable=""> Nigeria </div>
<div id="choices--country-item-choice-141" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="141" data-value="169" data-select-text="" data-choice-selectable=""> Niué </div>
<div id="choices--country-item-choice-142" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="142" data-value="166" data-select-text="" data-choice-selectable=""> Norvège </div>
<div id="choices--country-item-choice-143" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="143" data-value="170" data-select-text="" data-choice-selectable=""> Nouvelle Zélande
</div>
<div id="choices--country-item-choice-144" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="144" data-value="160" data-select-text="" data-choice-selectable=""> Nouvelle-Calédonie
</div>
<div id="choices--country-item-choice-145" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="145" data-value="175" data-select-text="" data-choice-selectable="">
Nouvelle-Guinée-Papouasie </div>
<div id="choices--country-item-choice-146" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="146" data-value="167" data-select-text="" data-choice-selectable=""> Népal </div>
<div id="choices--country-item-choice-147" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="147" data-value="171" data-select-text="" data-choice-selectable=""> Oman </div>
<div id="choices--country-item-choice-148" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="148" data-value="230" data-select-text="" data-choice-selectable=""> Ouganda </div>
<div id="choices--country-item-choice-149" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="149" data-value="235" data-select-text="" data-choice-selectable=""> Ouzbékistan </div>
<div id="choices--country-item-choice-150" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="150" data-value="177" data-select-text="" data-choice-selectable=""> Pakistan </div>
<div id="choices--country-item-choice-151" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="151" data-value="184" data-select-text="" data-choice-selectable=""> Palau </div>
<div id="choices--country-item-choice-152" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="152" data-value="182" data-select-text="" data-choice-selectable=""> Palestine </div>
<div id="choices--country-item-choice-153" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="153" data-value="172" data-select-text="" data-choice-selectable=""> Panama </div>
<div id="choices--country-item-choice-154" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="154" data-value="185" data-select-text="" data-choice-selectable=""> Paraguay </div>
<div id="choices--country-item-choice-155" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="155" data-value="165" data-select-text="" data-choice-selectable=""> Pays-Bas </div>
<div id="choices--country-item-choice-156" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="156" data-value="176" data-select-text="" data-choice-selectable=""> Philippines </div>
<div id="choices--country-item-choice-157" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="157" data-value="178" data-select-text="" data-choice-selectable=""> Pologne </div>
<div id="choices--country-item-choice-158" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="158" data-value="174" data-select-text="" data-choice-selectable=""> Polynésie française
</div>
<div id="choices--country-item-choice-159" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="159" data-value="181" data-select-text="" data-choice-selectable=""> Porto Rico </div>
<div id="choices--country-item-choice-160" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="160" data-value="183" data-select-text="" data-choice-selectable=""> Portugal </div>
<div id="choices--country-item-choice-161" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="161" data-value="173" data-select-text="" data-choice-selectable=""> Pérou </div>
<div id="choices--country-item-choice-162" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="162" data-value="186" data-select-text="" data-choice-selectable=""> Qatar </div>
<div id="choices--country-item-choice-163" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="163" data-value="188" data-select-text="" data-choice-selectable=""> Roumanie </div>
<div id="choices--country-item-choice-164" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="164" data-value="231" data-select-text="" data-choice-selectable=""> Royaume-Uni </div>
<div id="choices--country-item-choice-165" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="165" data-value="191" data-select-text="" data-choice-selectable=""> Rwanda </div>
<div id="choices--country-item-choice-166" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="166" data-value="40" data-select-text="" data-choice-selectable=""> République
Centre-Africaine </div>
<div id="choices--country-item-choice-167" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="167" data-value="61" data-select-text="" data-choice-selectable=""> République
Dominicaine </div>
<div id="choices--country-item-choice-168" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="168" data-value="41" data-select-text="" data-choice-selectable=""> République
démocratique du Congo </div>
<div id="choices--country-item-choice-169" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="169" data-value="56" data-select-text="" data-choice-selectable=""> République tchèque
</div>
<div id="choices--country-item-choice-170" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="170" data-value="66" data-select-text="" data-choice-selectable=""> Sahara Occidental
</div>
<div id="choices--country-item-choice-171" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="171" data-value="26" data-select-text="" data-choice-selectable=""> Saint Barthélémy
</div>
<div id="choices--country-item-choice-172" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="172" data-value="179" data-select-text="" data-choice-selectable=""> Saint Pierre et
Miquelon </div>
<div id="choices--country-item-choice-173" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="173" data-value="119" data-select-text="" data-choice-selectable="">
Saint-Christophe-et-Niévès </div>
<div id="choices--country-item-choice-174" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="174" data-value="140" data-select-text="" data-choice-selectable=""> Saint-Martin (partie
française) </div>
<div id="choices--country-item-choice-175" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="175" data-value="210" data-select-text="" data-choice-selectable=""> Saint-Martin (partie
néerlandaise) </div>
<div id="choices--country-item-choice-176" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="176" data-value="236" data-select-text="" data-choice-selectable=""> Saint-Siège (État du
Vatican) </div>
<div id="choices--country-item-choice-177" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="177" data-value="237" data-select-text="" data-choice-selectable="">
Saint-Vincent-et-les-Grenadines </div>
<div id="choices--country-item-choice-178" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="178" data-value="198" data-select-text="" data-choice-selectable=""> Sainte-Hélène,
Ascension et Tristan da Cunha, </div>
<div id="choices--country-item-choice-179" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="179" data-value="127" data-select-text="" data-choice-selectable=""> Sainte-Lucie </div>
<div id="choices--country-item-choice-180" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="180" data-value="209" data-select-text="" data-choice-selectable=""> Salvador </div>
<div id="choices--country-item-choice-181" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="181" data-value="244" data-select-text="" data-choice-selectable=""> Samoa </div>
<div id="choices--country-item-choice-182" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="182" data-value="11" data-select-text="" data-choice-selectable=""> Samoa américaines
</div>
<div id="choices--country-item-choice-183" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="183" data-value="203" data-select-text="" data-choice-selectable=""> San-Marin </div>
<div id="choices--country-item-choice-184" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="184" data-value="208" data-select-text="" data-choice-selectable=""> Sao Tomé-et-Principe
</div>
<div id="choices--country-item-choice-185" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="185" data-value="189" data-select-text="" data-choice-selectable=""> Serbie </div>
<div id="choices--country-item-choice-186" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="186" data-value="194" data-select-text="" data-choice-selectable=""> Seychelles </div>
<div id="choices--country-item-choice-187" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="187" data-value="202" data-select-text="" data-choice-selectable=""> Sierra Leone </div>
<div id="choices--country-item-choice-188" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="188" data-value="197" data-select-text="" data-choice-selectable=""> Singapour </div>
<div id="choices--country-item-choice-189" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="189" data-value="201" data-select-text="" data-choice-selectable=""> Slovaquie </div>
<div id="choices--country-item-choice-190" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="190" data-value="199" data-select-text="" data-choice-selectable=""> Slovénie </div>
<div id="choices--country-item-choice-191" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="191" data-value="205" data-select-text="" data-choice-selectable=""> Somalie </div>
<div id="choices--country-item-choice-192" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="192" data-value="195" data-select-text="" data-choice-selectable=""> Soudan </div>
<div id="choices--country-item-choice-193" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="193" data-value="129" data-select-text="" data-choice-selectable=""> Sri Lanka </div>
<div id="choices--country-item-choice-194" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="194" data-value="207" data-select-text="" data-choice-selectable=""> Sud Soudan </div>
<div id="choices--country-item-choice-195" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="195" data-value="43" data-select-text="" data-choice-selectable=""> Suisse </div>
<div id="choices--country-item-choice-196" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="196" data-value="206" data-select-text="" data-choice-selectable=""> Suriname </div>
<div id="choices--country-item-choice-197" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="197" data-value="196" data-select-text="" data-choice-selectable=""> Suède </div>
<div id="choices--country-item-choice-198" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="198" data-value="200" data-select-text="" data-choice-selectable=""> Svalbard et Jan
Mayen </div>
<div id="choices--country-item-choice-199" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="199" data-value="212" data-select-text="" data-choice-selectable=""> Swaziland </div>
<div id="choices--country-item-choice-200" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="200" data-value="211" data-select-text="" data-choice-selectable=""> Syrie </div>
<div id="choices--country-item-choice-201" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="201" data-value="204" data-select-text="" data-choice-selectable=""> Sénégal </div>
<div id="choices--country-item-choice-202" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="202" data-value="218" data-select-text="" data-choice-selectable=""> Tadjikistan </div>
<div id="choices--country-item-choice-203" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="203" data-value="228" data-select-text="" data-choice-selectable=""> Tanzanie </div>
<div id="choices--country-item-choice-204" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="204" data-value="227" data-select-text="" data-choice-selectable=""> Taïwan </div>
<div id="choices--country-item-choice-205" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="205" data-value="214" data-select-text="" data-choice-selectable=""> Tchad </div>
<div id="choices--country-item-choice-206" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="206" data-value="215" data-select-text="" data-choice-selectable=""> Terres Australes
Françaises </div>
<div id="choices--country-item-choice-207" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="207" data-value="105" data-select-text="" data-choice-selectable=""> Territoire
britannique de l'océan Indien </div>
<div id="choices--country-item-choice-208" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="208" data-value="217" data-select-text="" data-choice-selectable=""> Thaïlande </div>
<div id="choices--country-item-choice-209" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="209" data-value="223" data-select-text="" data-choice-selectable=""> Timor oriental
</div>
<div id="choices--country-item-choice-210" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="210" data-value="216" data-select-text="" data-choice-selectable=""> Togo </div>
<div id="choices--country-item-choice-211" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="211" data-value="219" data-select-text="" data-choice-selectable=""> Tokelau </div>
<div id="choices--country-item-choice-212" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="212" data-value="222" data-select-text="" data-choice-selectable=""> Tonga </div>
<div id="choices--country-item-choice-213" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="213" data-value="225" data-select-text="" data-choice-selectable=""> Trinité et Tobago
</div>
<div id="choices--country-item-choice-214" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="214" data-value="221" data-select-text="" data-choice-selectable=""> Tunisie </div>
<div id="choices--country-item-choice-215" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="215" data-value="220" data-select-text="" data-choice-selectable=""> Turkménistan </div>
<div id="choices--country-item-choice-216" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="216" data-value="224" data-select-text="" data-choice-selectable=""> Turquie </div>
<div id="choices--country-item-choice-217" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="217" data-value="226" data-select-text="" data-choice-selectable=""> Tuvalu </div>
<div id="choices--country-item-choice-218" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="218" data-value="229" data-select-text="" data-choice-selectable=""> Ukraine </div>
<div id="choices--country-item-choice-219" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="219" data-value="234" data-select-text="" data-choice-selectable=""> Uruguay </div>
<div id="choices--country-item-choice-220" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="220" data-value="242" data-select-text="" data-choice-selectable=""> Vanuatu </div>
<div id="choices--country-item-choice-221" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="221" data-value="238" data-select-text="" data-choice-selectable=""> Venezuela </div>
<div id="choices--country-item-choice-222" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="222" data-value="241" data-select-text="" data-choice-selectable=""> Vietnam </div>
<div id="choices--country-item-choice-223" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="223" data-value="243" data-select-text="" data-choice-selectable=""> Wallis et Futuna
</div>
<div id="choices--country-item-choice-224" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="224" data-value="245" data-select-text="" data-choice-selectable=""> Yémen </div>
<div id="choices--country-item-choice-225" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="225" data-value="248" data-select-text="" data-choice-selectable=""> Zambie </div>
<div id="choices--country-item-choice-226" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="226" data-value="249" data-select-text="" data-choice-selectable=""> Zimbabwe </div>
<div id="choices--country-item-choice-227" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="227" data-value="65" data-select-text="" data-choice-selectable=""> Égypte </div>
<div id="choices--country-item-choice-228" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="228" data-value="2" data-select-text="" data-choice-selectable=""> Émirats Arabes Unis
</div>
<div id="choices--country-item-choice-229" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="229" data-value="63" data-select-text="" data-choice-selectable=""> Équateur </div>
<div id="choices--country-item-choice-230" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="230" data-value="67" data-select-text="" data-choice-selectable=""> Érythrée </div>
<div id="choices--country-item-choice-231" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="231" data-value="233" data-select-text="" data-choice-selectable=""> États Unis </div>
<div id="choices--country-item-choice-232" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="232" data-value="69" data-select-text="" data-choice-selectable=""> Éthiopie </div>
<div id="choices--country-item-choice-233" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="233" data-value="34" data-select-text="" data-choice-selectable=""> Île Bouvet </div>
<div id="choices--country-item-choice-234" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="234" data-value="54" data-select-text="" data-choice-selectable=""> Île Christmas </div>
<div id="choices--country-item-choice-235" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="235" data-value="162" data-select-text="" data-choice-selectable=""> Île Norfolk </div>
<div id="choices--country-item-choice-236" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="236" data-value="103" data-select-text="" data-choice-selectable=""> Île de Man </div>
<div id="choices--country-item-choice-237" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="237" data-value="123" data-select-text="" data-choice-selectable=""> Îles Caïmans </div>
<div id="choices--country-item-choice-238" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="238" data-value="39" data-select-text="" data-choice-selectable=""> Îles Cocos (Keeling)
</div>
<div id="choices--country-item-choice-239" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="239" data-value="45" data-select-text="" data-choice-selectable=""> Îles Cook </div>
<div id="choices--country-item-choice-240" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="240" data-value="72" data-select-text="" data-choice-selectable=""> Îles Falkland </div>
<div id="choices--country-item-choice-241" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="241" data-value="74" data-select-text="" data-choice-selectable=""> Îles Féroé </div>
<div id="choices--country-item-choice-242" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="242" data-value="95" data-select-text="" data-choice-selectable=""> Îles Heard et
McDonald </div>
<div id="choices--country-item-choice-243" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="243" data-value="148" data-select-text="" data-choice-selectable=""> Îles Mariannes
Septentrionales </div>
<div id="choices--country-item-choice-244" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="244" data-value="142" data-select-text="" data-choice-selectable=""> Îles Marshall </div>
<div id="choices--country-item-choice-245" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="245" data-value="180" data-select-text="" data-choice-selectable=""> Îles Pitcairn </div>
<div id="choices--country-item-choice-246" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="246" data-value="193" data-select-text="" data-choice-selectable=""> Îles Salomon </div>
<div id="choices--country-item-choice-247" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="247" data-value="213" data-select-text="" data-choice-selectable=""> Îles Turques et
Caïques </div>
<div id="choices--country-item-choice-248" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="248" data-value="239" data-select-text="" data-choice-selectable=""> Îles Vierges
(Britaniques) </div>
<div id="choices--country-item-choice-249" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="249" data-value="240" data-select-text="" data-choice-selectable=""> Îles Vierges (USA)
</div>
<div id="choices--country-item-choice-250" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="250" data-value="232" data-select-text="" data-choice-selectable=""> Îles mineures
éloignées des États-Unis </div>
</div>
</div>
</div>
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Téléphone 1</span>
<span class="c-subinfo">(un téléphone obligatoire)</span>
<input type="text" placeholder="Ex. : 0143097856" name="phone" required="" title="Veuillez saisir un n° de téléphone.">
<p class="c-form__input-info">Ex: 0143097856</p>
</div>
<div class="c-form__input-container">
<span class="c-form__label">Téléphone 2</span>
<input type="text" placeholder="Ex. : 0143097856" name="mobile">
<p class="c-form__input-info">Ex: 0143097856</p>
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Adresse 1</span>
<input type="text" placeholder="Ex. : 3 rue du cerf" name="street" required="" title="Veuillez saisir une adresse postale.">
</div>
<div class="c-form__input-container">
<span class="c-form__label">Adresse 2</span>
<input type="text" placeholder="Ex. : 3 rue du cerf" name="street2">
</div>
<div class="c-form__input-container">
<span class="c-form__label">Adresse 3</span>
<input type="text" placeholder="Ex.: 3 rue du cerf" name="street3">
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Code postal</span>
<input type="text" placeholder="Ex. : 27000" name="zip" required="">
</div>
<div class="c-form__input-container c-form-city">
<span class="c-form__label c-form__label--required">Ville</span>
<div class="div_select">
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="select choices__input" name="select_city" title="Veuillez saisir votre ville." hidden="" tabindex="-1" data-choice="active">
<option value="">Ex. : Paris</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true" data-deletable="">Ex. : Paris<button type="button" class="choices__button"
aria-label="Remove item: ''" data-button="">Remove item</button></div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="Ex. : Paris" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--select_city-kl-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="" data-choice-selectable="" aria-selected="true">Ex. : Paris</div>
</div>
</div>
</div>
</div>
<input type="text" name="input_city" placeholder="Ex. : Paris" title="Veuillez saisir une ville." style="display:none;">
</div>
<div class="c-form__input-container c-form-choice-firstaid">
<span class="c-form__label">Avez-vous une formation de 1ers secours, d'évacuation ou d'incendie ?</span>
<p class="c-form__info">Vous avez une formation aux premiers secours ? au secours incendie ? Vous êtes le premier maillon de la chaîne des secours. Faites-le savoir dans les campings ! </p>
<div>
<div class="c-custom-radio">
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="firstaid" value="Oui">
<span class="c-custom-radio__name">Oui</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="firstaid" value="Non">
<span class="c-custom-radio__name">Non</span>
</label>
</div>
</div>
</div>
<div class="c-form__input-container c-form-firstaid" style="display:none;">
<span class="c-form__label">Laquelle ?</span>
<span class="c-subinfo">(plusieurs choix possibles)</span>
<div class="c-custom-checkbox">
<input class="c-custom-checkbox__choice c-training-group" type="checkbox" name="training_3" id="training_3" value="3">
<label class="c-custom-checkbox__name" for="training_3"> Evacuation </label>
<input class="c-custom-checkbox__choice c-training-group" type="checkbox" name="training_2" data-no-display="True" id="training_2" value="2">
<label class="c-custom-checkbox__name" for="training_2"> Incendie </label>
<input class="c-custom-checkbox__choice c-training-group" type="checkbox" name="training_1" data-no-display="True" id="training_1" value="1">
<label class="c-custom-checkbox__name" for="training_1"> Premiers secours </label>
</div>
</div>
<p class="c-form__step-title"><span class="c-form__step-title-number">2/</span>2 - Informations personnelles de ma famille </p>
<div class="c-form-card c-form-card-member-default" style="display:none;" id="" data-index="">
<div class="row">
<div class="col-12 col-md-6 col-lg-4 col-xl-6 c-form-title-member">
<p class="c-page-title c-page-title--tertiary">
<span class="c-page-firstname">
</span>
<span class="c-page-lastname">
</span>
</p>
</div>
<div class="col-6 col-md-3 col-lg-3 col-lg-4 col-xl-3 c-form-button-member">
<button type="button" class="c-btn c-btn--edit">Modifier</button>
</div>
<div class="col-6 col-md-3 col-lg-3 col-lg-4 col-xl-3 c-form-button-member">
<button type="button" class="c-btn c-btn--remove">Supprimer</button>
</div>
</div>
</div>
<div class="row c-membership-to-pay"></div>
<div class="c-separator c-separator-new-member"></div>
<div class="c-form__family-member-buttons c-form__family-member-buttons-add">
<button type="button" class="c-btn c-btn--link"> Ajouter un membre de la famille </button>
<button type="button" class="c-btn c-btn--add c-btn-add-member" aria-label="add-member"></button>
</div>
<div class="c-form__family-member-default-bloc">
<div style="display:none;margin-top:15px;" class="c-form__family-member-buttons-default" id="">
<button type="button" class="c-btn c-btn--link">
<span class="c-page-firstname">
</span>
<span class="c-page-lastname">
</span>
</button>
<button type="button" class="c-btn c-btn--delete c-btn-cancel-member" aria-label="cancel-member"></button>
</div>
<div class="c-form__family-member-div-default" id="" data-index="" data-member-id="">
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Civilité</span>
<div>
<div class="c-custom-radio">
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="member_default_title" value="1">
<span class="c-custom-radio__name">Madame</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" name="member_default_title" value="3">
<span class="c-custom-radio__name">Monsieur</span>
</label>
</div>
</div>
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Nom</span>
<input type="text" placeholder="Ex. : Dupont" name="member_default_lastname">
</div>
<div class="c-form__input-container">
<span class="c-form__label c-form__label--required">Prénom</span>
<input type="text" placeholder="Ex. : Bertrand" name="member_default_firstname">
</div>
<div class="c-form__input-container c-form-child-birthdate">
<span class="c-form__label c-form__label--required"> Date de naissance </span>
<div class="c-date-input">
<input type="text" data-toggle="datepicker-birthdate" placeholder="Ex. : XX/XX/XXXX" class="c-date-input__input" name="member_default_birthdate">
</div>
<p class="c-form__input-info">Ex: XX/XX/XXXX</p>
</div>
<div class="c-form__input-container c-form-status">
<span class="c-form__label c-form__label--required">Statut de la personne qui s'inscrit</span>
<div>
<div class="c-custom-radio c-custom-radio--small-padding">
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="1" data-adult="True" name="member_default_status">
<span class="c-custom-radio__name">Adulte</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="2" name="member_default_status">
<span class="c-custom-radio__name">Enfant</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="3" data-attached-child="True" name="member_default_status">
<span class="c-custom-radio__name">Enfant rattaché</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="4" name="member_default_status">
<span class="c-custom-radio__name">Petit-enfant</span>
</label>
</div>
</div>
</div>
<div class="c-form__input-container c-form-parental-consent" style="display:none;">
<span class="c-form__label">Autorisation parentale</span>
<p class="c-form__info">Mineurs rattachés : enfant dont vous aurez la garde pendant votre séjour, en dehors de vos propres enfants. Une attestation de ses parents est nécessaire pour l'adhésion. </p>
<div class="input-file-container">
<div class="file-return"></div>
<input class="input-file" type="file" id="my-file-default" name="member_default_file">
<label tabindex="0" class="input-file-trigger" for="my-file-default">Choisir un fichier</label>
</div>
<a href="https://gcu.asso.fr/sites/default/files/fichiers/pdf/INFORMATION%20PARENTALE_ER.pdf" target="_blank" rel="noopener">
<span class="detail">Téléchargez le modèle d’attestation</span>
</a>
</div>
<div class="c-form__input-container">
<span class="c-form__label">Adresse e-mail</span>
<input type="text" placeholder="Ex. : bertranddupont@gmail.com" class="email__input" name="member_default_email">
</div>
<div class="c-form__input-container">
<span class="c-form__label">Téléphone 1</span>
<input type="text" placeholder="Ex. : 0143097856" name="member_default_phone">
<p class="c-form__input-info">Ex: 0143097856</p>
</div>
<div class="c-form__input-container">
<span class="c-form__label">Ce membre a-t-il une formation de 1ers secours, d'évacuation ou d'incendie ?</span>
<p class="c-form__info">Ce membre a une formation aux premiers secours ? au secours incendie ? il est le premier maillon de la chaîne des secours. Faites-le savoir dans les campings !</p>
<div>
<div class="c-custom-radio">
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="Oui" name="member_default_firstaid">
<span class="c-custom-radio__name">Oui</span>
</label>
<label class="c-custom-radio__choice">
<input class="c-custom-radio__input" type="radio" value="Non" name="member_default_firstaid">
<span class="c-custom-radio__name">Non</span>
</label>
</div>
</div>
</div>
<div class="c-form__input-container c-form-child-firstaid" style="display:none;">
<span class="c-form__label">Laquelle ?</span><span class="c-subinfo"> (plusieurs choix possibles)</span>
<div class="c-custom-checkbox">
<input class="c-custom-checkbox__choice" type="checkbox" data-training="3" name="member_default_training_3" id="member_default_training_3" value="3">
<label class="c-custom-checkbox__name" for="member_default_training_3" data-training="3">Evacuation</label>
<input class="c-custom-checkbox__choice" type="checkbox" data-training="2" data-no-display="True" name="member_default_training_2" id="member_default_training_2" value="2">
<label class="c-custom-checkbox__name" for="member_default_training_2" data-training="2">Incendie</label>
<input class="c-custom-checkbox__choice" type="checkbox" data-training="1" data-no-display="True" name="member_default_training_1" id="member_default_training_1" value="1">
<label class="c-custom-checkbox__name" for="member_default_training_1" data-training="1">Premiers secours</label>
</div>
</div>
<div class="c-form__validation-btn-container">
<button type="button" class="c-btn c-btn--secondary c-btn-cancel-member" style="display:none;"> Annuler </button>
<button type="button" class="c-btn c-btn--secondary c-btn-valid-member" data-index=""> Valider ce membre </button>
</div>
</div>
</div>
<div class="c-separator c-separator-form u-hidden--tablet"></div>
<div class="c-form__next-step-btn-container u-hidden--tablet">
<button type="submit" class="c-btn c-btn--primary-small"> Passer à l'étape suivante </button>
</div>
</form>Text Content
J'ADHÈRE AU GCU
Mes informations
Mes engagements
Paiement
1 / 3
Mes informations
JE RENSEIGNE MES INFORMATIONS
Complétez ce formulaire pour adhérer et faire adhérer votre famille. Chaque
membre recevra une carte et pourra camper partout en France.
* renseignements obligatoires
1/ 2 - Mes informations personnelles
Civilité
Madame Monsieur
Nom
Prénom
Date de naissance
Vous devez être majeur pour adhérer en tant qu’adhérent principal au GCU.
Ex: XX/XX/XXXX
Adresse e-mail
Pays
France
France Remove item
Afghanistan
Afrique du sud
Albanie
Algérie
Allemagne
Andorre
Angola
Anguilla
Antarctique
Antigua et Barbuda
Arabie Saoudite
Argentine
Arménie
Aruba
Australie
Autriche
Azerbaïdjan
Bahamas
Bahreïn
Barbade
Belgique
Bengladesh
Bermudes
Bhoutan
Birmanie
Biélorussie
Bolivie
Bonaire, Saint-Eustache et Saba
Bosnie-Herzégovine
Botswana
Brunéi Darussalam
Brésil
Bulgarie
Burkina Faso
Burundi
Bénin
Cambodge
Cameroun
Canada
Cap-Vert
Chili
Chine
Chypre
Colombie
Comores
Congo
Corée du Nord
Corée du Sud
Costa Rica
Croatie
Cuba
Curaçao
Côte d'Ivoire
Danemark
Djibouti
Dominique
Espagne
Estonie
Fiji
Finlande
France
Fédération de Russie
Gabon
Gambie
Georgie
Ghana
Gibraltar
Grenade
Groënland
Grèce
Guadeloupe
Guam
Guatemala
Guernesey
Guinée
Guinée Équatoriale
Guinée-Bissau
Guyane
Guyane française
Géorgie du Sud-et-les Îles Sandwich du Sud
Haïti
Honduras
Hong-Kong
Hongrie
Iles Åland
Inde
Indonésie
Irak
Iran
Irlande
Islande
Israël
Italie
Jamaïque
Japon
Jersey
Jordanie
Kazakhstan
Kenya
Kirghizistan
Kiribati
Kosovo
Koweït
La Réunion
Laos
Le Belize
Lesotho
Lettonie
Liban
Liberia
Libye
Liechtenstein
Lituanie
Luxembourg
Macao
Macédoine, ancienne république yougoslave
Madagascar
Malaisie
Malawi
Maldives
Mali
Malte
Maroc
Martinique
Maurice
Mauritanie
Mayotte
Mexique
Micronésie
Moldavie
Monaco
Mongolie
Montenegro
Montserrat
Mozambique
Namibie
Nauru
Nicaragua
Niger
Nigeria
Niué
Norvège
Nouvelle Zélande
Nouvelle-Calédonie
Nouvelle-Guinée-Papouasie
Népal
Oman
Ouganda
Ouzbékistan
Pakistan
Palau
Palestine
Panama
Paraguay
Pays-Bas
Philippines
Pologne
Polynésie française
Porto Rico
Portugal
Pérou
Qatar
Roumanie
Royaume-Uni
Rwanda
République Centre-Africaine
République Dominicaine
République démocratique du Congo
République tchèque
Sahara Occidental
Saint Barthélémy
Saint Pierre et Miquelon
Saint-Christophe-et-Niévès
Saint-Martin (partie française)
Saint-Martin (partie néerlandaise)
Saint-Siège (État du Vatican)
Saint-Vincent-et-les-Grenadines
Sainte-Hélène, Ascension et Tristan da Cunha,
Sainte-Lucie
Salvador
Samoa
Samoa américaines
San-Marin
Sao Tomé-et-Principe
Serbie
Seychelles
Sierra Leone
Singapour
Slovaquie
Slovénie
Somalie
Soudan
Sri Lanka
Sud Soudan
Suisse
Suriname
Suède
Svalbard et Jan Mayen
Swaziland
Syrie
Sénégal
Tadjikistan
Tanzanie
Taïwan
Tchad
Terres Australes Françaises
Territoire britannique de l'océan Indien
Thaïlande
Timor oriental
Togo
Tokelau
Tonga
Trinité et Tobago
Tunisie
Turkménistan
Turquie
Tuvalu
Ukraine
Uruguay
Vanuatu
Venezuela
Vietnam
Wallis et Futuna
Yémen
Zambie
Zimbabwe
Égypte
Émirats Arabes Unis
Équateur
Érythrée
États Unis
Éthiopie
Île Bouvet
Île Christmas
Île Norfolk
Île de Man
Îles Caïmans
Îles Cocos (Keeling)
Îles Cook
Îles Falkland
Îles Féroé
Îles Heard et McDonald
Îles Mariannes Septentrionales
Îles Marshall
Îles Pitcairn
Îles Salomon
Îles Turques et Caïques
Îles Vierges (Britaniques)
Îles Vierges (USA)
Îles mineures éloignées des États-Unis
Téléphone 1 (un téléphone obligatoire)
Ex: 0143097856
Téléphone 2
Ex: 0143097856
Adresse 1
Adresse 2
Adresse 3
Code postal
Ville
Ex. : Paris
Ex. : ParisRemove item
Ex. : Paris
Avez-vous une formation de 1ers secours, d'évacuation ou d'incendie ?
Vous avez une formation aux premiers secours ? au secours incendie ? Vous êtes
le premier maillon de la chaîne des secours. Faites-le savoir dans les campings
!
Oui Non
Laquelle ? (plusieurs choix possibles)
Evacuation Incendie Premiers secours
2/2 - Informations personnelles de ma famille
Modifier
Supprimer
Ajouter un membre de la famille
Civilité
Madame Monsieur
Nom
Prénom
Date de naissance
Ex: XX/XX/XXXX
Statut de la personne qui s'inscrit
Adulte Enfant Enfant rattaché Petit-enfant
Autorisation parentale
Mineurs rattachés : enfant dont vous aurez la garde pendant votre séjour, en
dehors de vos propres enfants. Une attestation de ses parents est nécessaire
pour l'adhésion.
Choisir un fichier
Téléchargez le modèle d’attestation
Adresse e-mail
Téléphone 1
Ex: 0143097856
Ce membre a-t-il une formation de 1ers secours, d'évacuation ou d'incendie ?
Ce membre a une formation aux premiers secours ? au secours incendie ? il est le
premier maillon de la chaîne des secours. Faites-le savoir dans les campings !
Oui Non
Laquelle ? (plusieurs choix possibles)
Evacuation Incendie Premiers secours
Annuler Valider ce membre
Passer à l'étape suivante
Récapitulatif du montant
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