{"id":1058,"date":"2025-01-23T17:57:37","date_gmt":"2025-01-23T17:57:37","guid":{"rendered":"https:\/\/capdecreusdive.com\/form\/"},"modified":"2026-03-21T00:42:33","modified_gmt":"2026-03-21T00:42:33","slug":"form","status":"publish","type":"page","link":"https:\/\/capdecreusdive.com\/en\/form\/","title":{"rendered":"Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1058\" class=\"elementor elementor-1058 elementor-448\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e6f6381 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"e6f6381\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-83444b2\" data-id=\"83444b2\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-53f8b06 elementor--v-position-bottom elementor--h-position-center elementor-arrows-position-inside elementor-pagination-position-inside elementor-widget elementor-widget-slides\" data-id=\"53f8b06\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;navigation&quot;:&quot;both&quot;,&quot;autoplay&quot;:&quot;yes&quot;,&quot;pause_on_hover&quot;:&quot;yes&quot;,&quot;pause_on_interaction&quot;:&quot;yes&quot;,&quot;autoplay_speed&quot;:5000,&quot;infinite&quot;:&quot;yes&quot;,&quot;transition&quot;:&quot;slide&quot;,&quot;transition_speed&quot;:500}\" data-widget_type=\"slides.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-swiper\">\n\t\t\t\t\t<div class=\"elementor-slides-wrapper elementor-main-swiper swiper\" role=\"region\" aria-roledescription=\"carousel\" aria-label=\"Slides\" dir=\"ltr\" data-animation=\"fadeInUp\">\n\t\t\t\t<div class=\"swiper-wrapper elementor-slides\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-repeater-item-e297d7b swiper-slide\" role=\"group\" aria-roledescription=\"slide\"><div class=\"swiper-slide-bg\" role=\"img\" aria-label=\"DCIM104GOPRO\"><\/div><div class=\"swiper-slide-inner\" ><div class=\"swiper-slide-contents\"><div class=\"elementor-slide-heading\">Explore, Dive, Discover.<\/div><\/div><\/div><\/div><div class=\"elementor-repeater-item-178a7b2 swiper-slide\" role=\"group\" aria-roledescription=\"slide\"><div class=\"swiper-slide-bg\" role=\"img\" aria-label=\"Underwater scuba diving selfie shot with selfie stick. Deep blue sea. Wide angle shot.\"><\/div><div class=\"swiper-slide-inner\" ><div class=\"swiper-slide-contents\"><div class=\"elementor-slide-heading\">Explore, Dive, Discover.<\/div><\/div><\/div><\/div><div class=\"elementor-repeater-item-9970c45 swiper-slide\" role=\"group\" aria-roledescription=\"slide\"><div class=\"swiper-slide-bg\" role=\"img\" aria-label=\"Front view on scuba divers group swimming who exploring deep dark ocean blue water against the backdrop of a coral reef. Male and female in flippers examines the seabed. Air bubbles. Active life.Dive.\"><\/div><div class=\"swiper-slide-inner\" ><div class=\"swiper-slide-contents\"><div class=\"elementor-slide-heading\">Explore, Dive, Discover.<\/div><\/div><\/div><\/div><div class=\"elementor-repeater-item-ef7dbd5 swiper-slide\" role=\"group\" aria-roledescription=\"slide\"><div class=\"swiper-slide-bg\" role=\"img\" aria-label=\"slide-5\"><\/div><div class=\"swiper-slide-inner\" ><div class=\"swiper-slide-contents\"><div class=\"elementor-slide-heading\">Explore, Dive, Discover.<\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-swiper-button elementor-swiper-button-prev\" role=\"button\" tabindex=\"0\" aria-label=\"Previous slide\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-chevron-left\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M646 125C629 125 613 133 604 142L308 442C296 454 292 471 292 487 292 504 296 521 308 533L604 854C617 867 629 875 646 875 663 875 679 871 692 858 704 846 713 829 713 812 713 796 708 779 692 767L438 487 692 225C700 217 708 204 708 187 708 171 704 154 692 142 675 129 663 125 646 125Z\"><\/path><\/svg>\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"elementor-swiper-button elementor-swiper-button-next\" role=\"button\" tabindex=\"0\" aria-label=\"Next slide\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-chevron-right\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M696 533C708 521 713 504 713 487 713 471 708 454 696 446L400 146C388 133 375 125 354 125 338 125 325 129 313 142 300 154 292 171 292 187 292 204 296 221 308 233L563 492 304 771C292 783 288 800 288 817 288 833 296 850 308 863 321 871 338 875 354 875 371 875 388 867 400 854L696 533Z\"><\/path><\/svg>\t\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=\"swiper-pagination\"><\/div>\n\t\t\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\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2a87e34 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2a87e34\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4f23731\" data-id=\"4f23731\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bbdfdc1 elementor-widget elementor-widget-heading\" data-id=\"bbdfdc1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Participant Questions (confidential)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f9130a6 elementor-widget elementor-widget-text-editor\" data-id=\"f9130a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Diving requires good physical and mental health. There are some medical conditions that can be dangerous during diving, and they are listed below. Those who have or are predisposed to any of these conditions should be evaluated by a doctor. This Diver&#8217;s Medical Questionnaire provides a basis for determining whether you should seek this evaluation. If you have any concerns about your physical condition for diving and it is not represented in this form, consult your doctor before diving. References to &#8220;diving&#8221; in this form encompass both recreational diving with autonomous equipment and freediving. This form is primarily designed as an initial medical examination for new divers, but it is also appropriate for divers undergoing continuing education. For your safety and that of others who may dive with you, please answer all questions honestly.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-04a2a5d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"04a2a5d\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-0ed2eb4\" data-id=\"0ed2eb4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-6fea372\" data-id=\"6fea372\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-2e8c936\" data-id=\"2e8c936\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4b52601 elementor-widget elementor-widget-image\" data-id=\"4b52601\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"186\" height=\"171\" src=\"https:\/\/capdecreusdive.com\/wp-content\/uploads\/2025\/01\/ICONES-FORMULARI-8-form.png\" class=\"attachment-large size-large wp-image-998\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-53a0050 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"53a0050\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a5412ad\" data-id=\"a5412ad\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-e337962 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e337962\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-c502190\" data-id=\"c502190\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d5cfb92 elementor-widget elementor-widget-heading\" data-id=\"d5cfb92\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Instructions<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-50574e1 elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"50574e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1058\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"50574e1\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Form\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"1058\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_d0f25f2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d0f25f2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t  1. He tingut problemes amb els meus pulmons\/respiraci\u00f3, cor o sang. \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_d0f25f2-0\" name=\"form_fields[field_d0f25f2]\"> <label for=\"form-field-field_d0f25f2-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_d0f25f2-1\" name=\"form_fields[field_d0f25f2]\"> <label for=\"form-field-field_d0f25f2-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_c244c6f elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c244c6f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t2. I am over 45 years old.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_c244c6f-0\" name=\"form_fields[field_c244c6f]\"> <label for=\"form-field-field_c244c6f-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_c244c6f-1\" name=\"form_fields[field_c244c6f]\"> <label for=\"form-field-field_c244c6f-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_5ed11a9 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5ed11a9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t3. Is it difficult for me to perform moderate exercise (for example, walking 1.6 kilometers\/one mile in 12 minutes or swimming 200 meters\/yards without resting), or have I been unable to engage in normal physical activity due to reasons of physical or health status in the last 12 months?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_5ed11a9-0\" name=\"form_fields[field_5ed11a9]\"> <label for=\"form-field-field_5ed11a9-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_5ed11a9-1\" name=\"form_fields[field_5ed11a9]\"> <label for=\"form-field-field_5ed11a9-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_17e3651 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_17e3651\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t4. Have I had problems with my eyes, ears, or nasal\/sinus passages?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_17e3651-0\" name=\"form_fields[field_17e3651]\"> <label for=\"form-field-field_17e3651-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_17e3651-1\" name=\"form_fields[field_17e3651]\"> <label for=\"form-field-field_17e3651-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_4e91ce0 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4e91ce0\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t5. Have I had surgery in the last 12 months or do I have ongoing issues related to a previous surgery?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_4e91ce0-0\" name=\"form_fields[field_4e91ce0]\"> <label for=\"form-field-field_4e91ce0-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_4e91ce0-1\" name=\"form_fields[field_4e91ce0]\"> <label for=\"form-field-field_4e91ce0-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_119ff09 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_119ff09\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t6. Have I lost consciousness, had migraines, seizures, stroke, significant head injury, or suffered from persistent neurological injury or illness?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_119ff09-0\" name=\"form_fields[field_119ff09]\"> <label for=\"form-field-field_119ff09-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_119ff09-1\" name=\"form_fields[field_119ff09]\"> <label for=\"form-field-field_119ff09-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_792f8a4 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_792f8a4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t7. Have I had psychological problems (or received psychological treatment in the last 5 years), been diagnosed with a learning disability, personality disorder, panic attacks, or addiction to drugs or alcohol?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_792f8a4-0\" name=\"form_fields[field_792f8a4]\"> <label for=\"form-field-field_792f8a4-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_792f8a4-1\" name=\"form_fields[field_792f8a4]\"> <label for=\"form-field-field_792f8a4-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_2f3aec6 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2f3aec6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t8. Have I had problems with the back, hernia, ulcers, or diabetes?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_2f3aec6-0\" name=\"form_fields[field_2f3aec6]\"> <label for=\"form-field-field_2f3aec6-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_2f3aec6-1\" name=\"form_fields[field_2f3aec6]\"> <label for=\"form-field-field_2f3aec6-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_edbd2c1 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_edbd2c1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t9. Have I had stomach or intestinal problems, including recent diarrhea?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_edbd2c1-0\" name=\"form_fields[field_edbd2c1]\"> <label for=\"form-field-field_edbd2c1-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_edbd2c1-1\" name=\"form_fields[field_edbd2c1]\"> <label for=\"form-field-field_edbd2c1-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_44feec8 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_44feec8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t10. Am I taking prescribed medications (with the exception of contraceptives or antimalarial drugs other than Lariam-mefloquine)?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_44feec8-0\" name=\"form_fields[field_44feec8]\"> <label for=\"form-field-field_44feec8-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_44feec8-1\" name=\"form_fields[field_44feec8]\"> <label for=\"form-field-field_44feec8-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_938b3c6 elementor-col-100\">\n\t\t\t\t\t<h4>Participant's Signature<\/h4>\n<br> Please read and accept the participant's declaration below with your signature. Participant's Declaration: I have answered all questions honestly, and I understand that I accept responsibility for any consequences resulting from any questions I may have answered inaccurately or for not disclosing any existing or past health condition.\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"NAME AND SURNAME\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_ef6499c elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_ef6499c]\" id=\"form-field-field_ef6499c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"EMAIL\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_011e6d8 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_011e6d8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBIRTHDAY DATE (dd\/mm\/YY)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_011e6d8]\" id=\"form-field-field_011e6d8\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_8943566 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8943566\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPARTICIPANT'S SIGNATURE\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_8943566]\" id=\"form-field-field_8943566\" class=\"elementor-field elementor-size-sm  elementor-upload-field\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">SEND<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-319408e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"319408e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-452906b\" data-id=\"452906b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-93454e4 elementor-absolute elementor-widget elementor-widget-image\" data-id=\"93454e4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_position&quot;:&quot;absolute&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"208\" height=\"534\" src=\"https:\/\/capdecreusdive.com\/wp-content\/uploads\/2025\/01\/medical-decoration@2x.png\" class=\"attachment-large size-large wp-image-1001\" alt=\"\" srcset=\"https:\/\/capdecreusdive.com\/wp-content\/uploads\/2025\/01\/medical-decoration@2x.png 208w, https:\/\/capdecreusdive.com\/wp-content\/uploads\/2025\/01\/medical-decoration@2x-117x300.png 117w\" sizes=\"(max-width: 208px) 100vw, 208px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-508fa84\" data-id=\"508fa84\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-38be8e8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"38be8e8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9e6fcde\" data-id=\"9e6fcde\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b30c9c2 elementor-widget elementor-widget-heading\" data-id=\"b30c9c2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">At Cap de Creus Dive, passion for adventure and nature is what drives us every day.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Explore, Dive, Discover.Explore, Dive, Discover.Explore, Dive, Discover.Explore, Dive, Discover. Participant Questions (confidential) Diving requires good physical and mental health. There [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","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":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","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":""}},"_joinchat":[],"footnotes":""},"class_list":["post-1058","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/pages\/1058","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/comments?post=1058"}],"version-history":[{"count":16,"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/pages\/1058\/revisions"}],"predecessor-version":[{"id":2048,"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/pages\/1058\/revisions\/2048"}],"wp:attachment":[{"href":"https:\/\/capdecreusdive.com\/en\/wp-json\/wp\/v2\/media?parent=1058"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}