{"id":1060,"date":"2025-01-23T17:57:37","date_gmt":"2025-01-23T17:57:37","guid":{"rendered":"https:\/\/capdecreusdive.com\/formulaire\/"},"modified":"2026-03-21T01:05:32","modified_gmt":"2026-03-21T01:05:32","slug":"formulaire","status":"publish","type":"page","link":"https:\/\/capdecreusdive.com\/fr\/formulaire\/","title":{"rendered":"Formulaire"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1060\" class=\"elementor elementor-1060 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\">Explorez, Plongez, D\u00e9couvrez.<\/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\">Explorez, Plongez, D\u00e9couvrez.<\/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\">Explorez, Plongez, D\u00e9couvrez.<\/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\">Explorez, Plongez, D\u00e9couvrez.<\/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=\"Diapositive pr\u00e9c\u00e9dente\">\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=\"Diapositive suivante\">\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\">Questionnaire du participant (confidentiel)<\/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>La plong\u00e9e sous-marine n\u00e9cessite une bonne sant\u00e9 physique et mentale. Certaines conditions m\u00e9dicales peuvent \u00eatre dangereuses lors de la pratique de la plong\u00e9e, et sont \u00e9num\u00e9r\u00e9es ci-dessous. Ceux qui ont ou sont pr\u00e9dispos\u00e9s \u00e0 l&rsquo;une de ces conditions doivent \u00eatre \u00e9valu\u00e9s par un m\u00e9decin. Ce Questionnaire M\u00e9dical du Plongeur fournit une base pour d\u00e9terminer si vous devez fournir cette \u00e9valuation. Si vous avez des doutes concernant votre condition physique pour la plong\u00e9e et ils ne pas compris dans ce formulaire, consultez votre m\u00e9decin. Les r\u00e9f\u00e9rences \u00e0 la \u00ab\u00a0plong\u00e9e\u00a0\u00bb dans ce formulaire englobent \u00e0 la fois la plong\u00e9e r\u00e9cr\u00e9ative en \u00e9quipement autonome et la plong\u00e9e en apn\u00e9e. Ce formulaire est principalement con\u00e7u comme un examen m\u00e9dical initial pour les nouveaux plongeurs, mais il convient \u00e9galement aux plongeurs qui suivent une formation continue. Pour votre s\u00e9curit\u00e9 et celle des autres personnes qui peuvent plonger avec vous, veuillez r\u00e9pondre honn\u00eatement \u00e0 toutes les questions.<\/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-999\" 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;Suivant&quot;,&quot;step_previous_label&quot;:&quot;Pr\\u00e9c\\u00e9dent&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=\"Nouvelle forme\" aria-label=\"Nouvelle forme\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1060\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"50574e1\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Formulaire\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"1060\"\/>\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=\"Oui\" id=\"form-field-field_d0f25f2-0\" name=\"form_fields[field_d0f25f2]\"> <label for=\"form-field-field_d0f25f2-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_d0f25f2-1\" name=\"form_fields[field_d0f25f2]\"> <label for=\"form-field-field_d0f25f2-1\">Non<\/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. J'ai plus de 45 ans.\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=\"Oui\" id=\"form-field-field_c244c6f-0\" name=\"form_fields[field_c244c6f]\"> <label for=\"form-field-field_c244c6f-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_c244c6f-1\" name=\"form_fields[field_c244c6f]\"> <label for=\"form-field-field_c244c6f-1\">Non<\/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. J\u2019ai des difficult\u00e9s pour r\u00e9aliser un exercice mod\u00e9r\u00e9 (par exemple, marcher 1,6 km en 12 minutes ou nager 200m sans pause), ou je n'ai pas pu participer \u00e0 une activit\u00e9 physique normale pour des raisons de conidions physiques ou de sant\u00e9 au cours des 12 derniers mois.\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=\"Oui\" id=\"form-field-field_5ed11a9-0\" name=\"form_fields[field_5ed11a9]\"> <label for=\"form-field-field_5ed11a9-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_5ed11a9-1\" name=\"form_fields[field_5ed11a9]\"> <label for=\"form-field-field_5ed11a9-1\">Non<\/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. J'ai eu des probl\u00e8mes d\u2019yeux, d\u2019oreilles ou de fosses nasales\/sinus paranasaux.\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=\"Oui\" id=\"form-field-field_17e3651-0\" name=\"form_fields[field_17e3651]\"> <label for=\"form-field-field_17e3651-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_17e3651-1\" name=\"form_fields[field_17e3651]\"> <label for=\"form-field-field_17e3651-1\">Non<\/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. J'ai subi une chirurgie au cours des 12 derniers mois ou j'ai des probl\u00e8mes continus li\u00e9s \u00e0 une chirurgie ant\u00e9rieure.\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=\"Oui\" id=\"form-field-field_4e91ce0-0\" name=\"form_fields[field_4e91ce0]\"> <label for=\"form-field-field_4e91ce0-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_4e91ce0-1\" name=\"form_fields[field_4e91ce0]\"> <label for=\"form-field-field_4e91ce0-1\">Non<\/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. J'ai perdu connaissance, j'ai eu des maux de t\u00eate de migraine, des convulsions, un accident vasculaire c\u00e9r\u00e9bral, une l\u00e9sion significative \u00e0 la t\u00eate ou j'ai souffert d'une l\u00e9sion ou d'une maladie neurologique persistante.\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=\"Oui\" id=\"form-field-field_119ff09-0\" name=\"form_fields[field_119ff09]\"> <label for=\"form-field-field_119ff09-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_119ff09-1\" name=\"form_fields[field_119ff09]\"> <label for=\"form-field-field_119ff09-1\">Non<\/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. He tingut problemes psicol\u00f2gics (o he rebut tractament psicol\u00f2gic en els \u00faltims 5 anys), m'han diagnosticat una discapacitat d'aprenentatge, trastorn de la personalitat, atacs de p\u00e0nic o una addicci\u00f3 a les drogues o a l'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=\"Oui\" id=\"form-field-field_792f8a4-0\" name=\"form_fields[field_792f8a4]\"> <label for=\"form-field-field_792f8a4-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_792f8a4-1\" name=\"form_fields[field_792f8a4]\"> <label for=\"form-field-field_792f8a4-1\">Non<\/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. He tingut problemes de la part posterior, h\u00e8rnia, \u00falceres o diabetis.\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=\"Oui\" id=\"form-field-field_2f3aec6-0\" name=\"form_fields[field_2f3aec6]\"> <label for=\"form-field-field_2f3aec6-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_2f3aec6-1\" name=\"form_fields[field_2f3aec6]\"> <label for=\"form-field-field_2f3aec6-1\">Non<\/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. He tingut problemes estomacals o intestinals, incloent-hi diarrea recent.\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=\"Oui\" id=\"form-field-field_edbd2c1-0\" name=\"form_fields[field_edbd2c1]\"> <label for=\"form-field-field_edbd2c1-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_edbd2c1-1\" name=\"form_fields[field_edbd2c1]\"> <label for=\"form-field-field_edbd2c1-1\">Non<\/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_db6a582 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_db6a582\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t10. Estic prenent medicaments recetats (amb l'excepci\u00f3 dels anticonceptius o els medicaments antipal\u00fadics que no siguin Lariam-mefloquina).\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=\"Oui\" id=\"form-field-field_db6a582-0\" name=\"form_fields[field_db6a582]\"> <label for=\"form-field-field_db6a582-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_db6a582-1\" name=\"form_fields[field_db6a582]\"> <label for=\"form-field-field_db6a582-1\">Non<\/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>Signature du Participant<\/h4>\n<br> Veuillez lire et accepter la d\u00e9claration du participant ci-dessous avec votre signature.<br>D\u00e9claration du Participant : J'ai r\u00e9pondu \u00e0 toutes les questions en toute honn\u00eatet\u00e9 et je comprends que j'assume la responsabilit\u00e9 de toute cons\u00e9quence r\u00e9sultant de toute question que j'aurais pu r\u00e9pondre de mani\u00e8re inexacte ou de ne pas avoir r\u00e9v\u00e9l\u00e9 toute condition de sant\u00e9 existante ou pass\u00e9e. \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=\"NOM ET PRENOM\">\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\tDATE DE NAISSANCE (dd\/mm\/aa)\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\tSIGNATURA DEL PARTICIPANT\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\">ENVOYER<\/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-1002\" 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\">\u00c0 Cap de Creus Dive, ce qui nous motive c\u2019est la passion pour l'aventure et la nature<\/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>Explorez, Plongez, D\u00e9couvrez.Explorez, Plongez, D\u00e9couvrez.Explorez, Plongez, D\u00e9couvrez.Explorez, Plongez, D\u00e9couvrez. Questionnaire du participant (confidentiel) La plong\u00e9e sous-marine n\u00e9cessite une bonne sant\u00e9 [&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-1060","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/pages\/1060","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/comments?post=1060"}],"version-history":[{"count":22,"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/pages\/1060\/revisions"}],"predecessor-version":[{"id":2075,"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/pages\/1060\/revisions\/2075"}],"wp:attachment":[{"href":"https:\/\/capdecreusdive.com\/fr\/wp-json\/wp\/v2\/media?parent=1060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}