{"id":7177,"date":"2024-03-14T08:40:43","date_gmt":"2024-03-14T07:40:43","guid":{"rendered":"https:\/\/archief.detour.be\/?page_id=7177"},"modified":"2025-01-07T17:03:54","modified_gmt":"2025-01-07T16:03:54","slug":"inschrijving-reis-naar-de-tt-2025","status":"publish","type":"page","link":"https:\/\/archief.detour.be\/fr\/inschrijving-reis-naar-de-tt-2025\/","title":{"rendered":"Voyage d'inscription au TT 2025"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_23' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_23'  action='\/fr\/wp-json\/wp\/v2\/pages\/7177' data-formid='23' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_23' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_23_59\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_59'><span class='gform-field-label__text'>LinkedIn<\/span><\/label><div class='gfield_description' id='gfield_description_23_59'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_59' id='input_23_59' type='text' value='' autocomplete='new-password'\/><\/div><\/li><li id=\"field_23_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Keuze van het programma<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_55'>Geef hier aan welk programma je wenst te reserveren.\nWe vragen 40% voorschot bij inschrijving, 30% tegen 31\/12\/2024 en het restsaldo is te voldoen ten laatste 28\/02\/2025.   Korting voor duo = \u20ac 250.\n\n<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_55'>\n\t\t\t<li class='gchoice gchoice_23_55_0'>\n\t\t\t\t<input name='input_55' type='radio' value='periode 1 (25\/05 - 02\/06\/2025) \u00e0 \u20ac 1825 per piloot (4 PLAATSEN)'  id='choice_23_55_0'    \/>\n\t\t\t\t<label for='choice_23_55_0' id='label_23_55_0' class='gform-field-label gform-field-label--type-inline'>periode 1 (25\/05 - 02\/06\/2025) \u00e0 \u20ac 1825 per piloot (4 PLAATSEN)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_55_1'>\n\t\t\t\t<input name='input_55' type='radio' value='periode 2 (31\/05 - 09\/06\/2025) \u00e0 \u20ac 2125 per piloot (VOLZET)'  id='choice_23_55_1'    \/>\n\t\t\t\t<label for='choice_23_55_1' id='label_23_55_1' class='gform-field-label gform-field-label--type-inline'>periode 2 (31\/05 - 09\/06\/2025) \u00e0 \u20ac 2125 per piloot (VOLZET)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_55_2'>\n\t\t\t\t<input name='input_55' type='radio' value='periode 3 (29\/05 -09\/06\/2025) \u00e0 \u20ac 2275 per piloot (VOLZET)'  id='choice_23_55_2'    \/>\n\t\t\t\t<label for='choice_23_55_2' id='label_23_55_2' class='gform-field-label gform-field-label--type-inline'>periode 3 (29\/05 -09\/06\/2025) \u00e0 \u20ac 2275 per piloot (VOLZET)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Voornaam + Naam<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_1'>1ste voornaam en naam (exact zoals op het  identiteitsdocument vermeld)<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_23_1'>\n                            \n                            <span id='input_23_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_23_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_23_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_23_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_23_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_23_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_23_4\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_4'><span class='gform-field-label__text'>GSM<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_23_4' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_23_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_5'><span class='gform-field-label__text'>E-mailadres<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_23_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_23_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Hebt u al met D\u00e9tour gereisd?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_14'>\n\t\t\t<li class='gchoice gchoice_23_14_0'>\n\t\t\t\t<input name='input_14' type='radio' value='nee, ik ben een nieuwe klant'  id='choice_23_14_0'    \/>\n\t\t\t\t<label for='choice_23_14_0' id='label_23_14_0' class='gform-field-label gform-field-label--type-inline'>nee, ik ben een nieuwe klant<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_14_1'>\n\t\t\t\t<input name='input_14' type='radio' value='ja, ik ben een bestaande klant en reis met dezelfde motor als laatste reis'  id='choice_23_14_1'    \/>\n\t\t\t\t<label for='choice_23_14_1' id='label_23_14_1' class='gform-field-label gform-field-label--type-inline'>ja, ik ben een bestaande klant en reis met dezelfde motor als laatste reis<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_14_2'>\n\t\t\t\t<input name='input_14' type='radio' value='ja, ik ben een bestaande klant maar reis met een andere motor'  id='choice_23_14_2'    \/>\n\t\t\t\t<label for='choice_23_14_2' id='label_23_14_2' class='gform-field-label gform-field-label--type-inline'>ja, ik ben een bestaande klant maar reis met een andere motor<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_10\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adres<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_23_10' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_23_10_1_container' >\n                                        <input type='text' name='input_10.1' id='input_23_10_1' value=''    aria-required='false'    \/>\n                                        <label for='input_23_10_1' id='input_23_10_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_23_10_3_container' >\n                                    <input type='text' name='input_10.3' id='input_23_10_3' value=''    aria-required='false'    \/>\n                                    <label for='input_23_10_3' id='input_23_10_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_10.4' id='input_23_10_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_23_10_5_container' >\n                                    <input type='text' name='input_10.5' id='input_23_10_5' value=''    aria-required='false'    \/>\n                                    <label for='input_23_10_5' id='input_23_10_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_23_10_6_container' >\n                                        <select name='input_10.6' id='input_23_10_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >\u00c5land Islands<\/option><option value='AL' >Albania<\/option><option value='DZ' >Algeria<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctica<\/option><option value='AG' >Antigua and Barbuda<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BY' >Belarus<\/option><option value='BE' selected='selected'>Belgium<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, Sint Eustatius and Saba<\/option><option value='BA' >Bosnia and Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet Island<\/option><option value='BR' >Brazil<\/option><option value='IO' >British Indian Ocean Territory<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='CV' >Cabo Verde<\/option><option value='KH' >Cambodia<\/option><option value='CM' >Cameroon<\/option><option value='CA' >Canada<\/option><option value='KY' >Cayman Islands<\/option><option value='CF' >Central African Republic<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CX' >Christmas Island<\/option><option value='CC' >Cocos Islands<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoros<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratic Republic of the<\/option><option value='CK' >Cook Islands<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >C\u00f4te d&#039;Ivoire<\/option><option value='HR' >Croatia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='CZ' >Czechia<\/option><option value='DK' >Denmark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominican Republic<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypt<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatorial Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/option><option value='FO' >Faroe Islands<\/option><option value='FJ' >Fiji<\/option><option value='FI' >Finland<\/option><option value='FR' >France<\/option><option value='GF' >French Guiana<\/option><option value='PF' >French Polynesia<\/option><option value='TF' >French Southern Territories<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='DE' >Germany<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Greece<\/option><option value='GL' >Greenland<\/option><option value='GD' >Grenada<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Haiti<\/option><option value='HM' >Heard Island and McDonald Islands<\/option><option value='VA' >Holy See<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungary<\/option><option value='IS' >Iceland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/option><option value='IM' >Isle of Man<\/option><option value='IL' >Israel<\/option><option value='IT' >Italy<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordan<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='KP' >Korea, Democratic People&#039;s Republic of<\/option><option value='KR' >Korea, Republic of<\/option><option value='KW' >Kuwait<\/option><option value='KG' >Kyrgyzstan<\/option><option value='LA' >Lao People&#039;s Democratic Republic<\/option><option value='LV' >Latvia<\/option><option value='LB' >Lebanon<\/option><option value='LS' >Lesotho<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libya<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lithuania<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao<\/option><option value='MG' >Madagascar<\/option><option value='MW' >Malawi<\/option><option value='MY' >Malaysia<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MH' >Marshall Islands<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritania<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldova<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MA' >Morocco<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NL' >Netherlands<\/option><option value='NC' >New Caledonia<\/option><option value='NZ' >New Zealand<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NF' >Norfolk Island<\/option><option value='MK' >North Macedonia<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norway<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestine, State of<\/option><option value='PA' >Panama<\/option><option value='PG' >Papua New Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Poland<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='RE' >R\u00e9union<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='SH' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='KN' >Saint Kitts and Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre and Miquelon<\/option><option value='VC' >Saint Vincent and the Grenadines<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tome and Principe<\/option><option value='SA' >Saudi Arabia<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovakia<\/option><option value='SI' >Slovenia<\/option><option value='SB' >Solomon Islands<\/option><option value='SO' >Somalia<\/option><option value='ZA' >South Africa<\/option><option value='GS' >South Georgia and the South Sandwich Islands<\/option><option value='SS' >South Sudan<\/option><option value='ES' >Spain<\/option><option value='LK' >Sri Lanka<\/option><option value='SD' >Sudan<\/option><option value='SR' >Suriname<\/option><option value='SJ' >Svalbard and Jan Mayen<\/option><option value='SE' >Sweden<\/option><option value='CH' >Switzerland<\/option><option value='SY' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the United Republic of<\/option><option value='TH' >Thailand<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad and Tobago<\/option><option value='TN' >Tunisia<\/option><option value='TR' >T\u00fcrkiye<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/option><option value='VG' >Virgin Islands, British<\/option><option value='VI' >Virgin Islands, U.S.<\/option><option value='WF' >Wallis and Futuna<\/option><option value='EH' >Western Sahara<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><\/select>\n                                        <label for='input_23_10_6' id='input_23_10_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_23_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_57'><span class='gform-field-label__text'>Geboortedatum piloot<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_23_57' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_23_12\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_12'><span class='gform-field-label__text'>Merk + type van uw motorfiets<\/span><\/label><div class='gfield_description' id='gfield_description_23_12'>eventuele latere wijzigingen van type motor moeten zo snel mogelijk meegedeeld worden, want dit is van belang voor de reservatie van de overtochten.<\/div><div class='ginput_container ginput_container_text'><input name='input_12' id='input_23_12' type='text' value='' class='medium'  aria-describedby=\"gfield_description_23_12\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_23_13\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_13'><span class='gform-field-label__text'>Nummerplaat<\/span><\/label><div class='gfield_description' id='gfield_description_23_13'>eventuele latere wijzigingen van nummerplaat moeten zo snel mogelijk meegedeeld worden, want dit is van belang voor de reservatie van de overtochten.<\/div><div class='ginput_container ginput_container_text'><input name='input_13' id='input_23_13' type='text' value='' class='medium'  aria-describedby=\"gfield_description_23_13\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_23_54\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_54'><span class='gform-field-label__text'>Jaar 1ste inschrijving motor<\/span><\/label><div class='gfield_description' id='gfield_description_23_54'>Jaar 1ste inschrijving hebben we nodig als je inschrijft voor onze optionele reisbijstandverzekering<\/div><div class='ginput_container ginput_container_text'><input name='input_54' id='input_23_54' type='text' value='' class='medium'  aria-describedby=\"gfield_description_23_54\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_23_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Duo?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_15'>\n\t\t\t<li class='gchoice gchoice_23_15_0'>\n\t\t\t\t<input name='input_15' type='radio' value='ik rij solo'  id='choice_23_15_0'    \/>\n\t\t\t\t<label for='choice_23_15_0' id='label_23_15_0' class='gform-field-label gform-field-label--type-inline'>ik rij solo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_15_1'>\n\t\t\t\t<input name='input_15' type='radio' value='ik boek ook voor mijn duopassagier'  id='choice_23_15_1'    \/>\n\t\t\t\t<label for='choice_23_15_1' id='label_23_15_1' class='gform-field-label gform-field-label--type-inline'>ik boek ook voor mijn duopassagier<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_16\" class=\"gfield gfield--type-name gfield--input-type-name field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Naam van de duopassagier<\/span><\/label><div class='gfield_description' id='gfield_description_23_16'>Naam en voornaam exact zoals op uw identiteitsdocument vermeld is.<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_23_16'>\n                            \n                            <span id='input_23_16_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.3' id='input_23_16_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_23_16_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_23_16_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.6' id='input_23_16_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_23_16_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_23_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_58'><span class='gform-field-label__text'>Geboortedatum duo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_23_58' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_23_17\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_17'><span class='gform-field-label__text'>GSM van de duopassagier<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_17' id='input_23_17' type='tel' value='' class='medium'    aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_23_18\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_18'><span class='gform-field-label__text'>E-mailadres van de duopassagier<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_23_18' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_23_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_23_19'><span class='gform-field-label__text'>Ik reis samen met \/ kamer delen met \/ opmerking<\/span><\/label><div class='gfield_description' id='gfield_description_23_19'>Indien u met \u00e9\u00e9n of meerdere rijders boekt, kan u dat hier laten weten.\nOok andere opmerkingen kunnen hier ingevoegd worden.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_23_19' class='textarea medium'  aria-describedby=\"gfield_description_23_19\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_23_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Keuze voor de ferry i.p.v. de Eurotunnel hier meedelen<\/span><\/label><div class='gfield_description' id='gfield_description_23_56'>Indien je geen keuze maakt hier, wordt standaard gekozen voor de Eurotunnel van Calais naar Folkestone.  Hou er rekening mee dat de nachtboot enkel interessant is voor wie in Nederland woont.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_56'>\n\t\t\t<li class='gchoice gchoice_23_56_0'>\n\t\t\t\t<input name='input_56' type='radio' value='Ik kies voor de Eurotunnel (standaard)'  id='choice_23_56_0'    \/>\n\t\t\t\t<label for='choice_23_56_0' id='label_23_56_0' class='gform-field-label gform-field-label--type-inline'>Ik kies voor de Eurotunnel (standaard)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_56_1'>\n\t\t\t\t<input name='input_56' type='radio' value='Bij voorkeur de nachtboot vanuit Hoek van Holland of Europort Rotterdam'  id='choice_23_56_1'    \/>\n\t\t\t\t<label for='choice_23_56_1' id='label_23_56_1' class='gform-field-label gform-field-label--type-inline'>Bij voorkeur de nachtboot vanuit Hoek van Holland of Europort Rotterdam<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Verzekering reisannulatie<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_26'>Deze polis bieden wij aan voor slechts 2,9 % supplement op de reissom (polis via Ethias).  We raden dergelijke verzekering ten zeerste aan.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_26'>\n\t\t\t<li class='gchoice gchoice_23_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='ja'  id='choice_23_26_0'    \/>\n\t\t\t\t<label for='choice_23_26_0' id='label_23_26_0' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='nee'  id='choice_23_26_1'    \/>\n\t\t\t\t<label for='choice_23_26_1' id='label_23_26_1' class='gform-field-label gform-field-label--type-inline'>nee<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reisbijstand motor \u00e0 4 \u20ac\/dag<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_28'>We raden een verzekering reisbijstand ten stelligste aan.  Deze kan ook via D\u00e9tour geboekt worden  (polis Ethias Privilege)\nopmerking: Op dit moment kunnen we deze polis enkel aanbieden voor personen gedomicilieerd in Belgi\u00eb.  \nDe reisbijstand personen moet verplicht bijgeboekt worden<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_28'>\n\t\t\t<li class='gchoice gchoice_23_28_0'>\n\t\t\t\t<input name='input_28' type='radio' value='ja'  id='choice_23_28_0'    \/>\n\t\t\t\t<label for='choice_23_28_0' id='label_23_28_0' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_28_1'>\n\t\t\t\t<input name='input_28' type='radio' value='nee'  id='choice_23_28_1'    \/>\n\t\t\t\t<label for='choice_23_28_1' id='label_23_28_1' class='gform-field-label gform-field-label--type-inline'>nee<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reisbijstand personen voor piloot \u00e0 2 \u20ac\/dag<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_31'>opmerking: Op dit moment kunnen we deze polis enkel aanbieden voor personen gedomicilieerd in Belgi\u00eb.\nDe reisbijstand personen is de minimale te verzekeren basis.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_31'>\n\t\t\t<li class='gchoice gchoice_23_31_0'>\n\t\t\t\t<input name='input_31' type='radio' value='ja'  id='choice_23_31_0'    \/>\n\t\t\t\t<label for='choice_23_31_0' id='label_23_31_0' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_31_1'>\n\t\t\t\t<input name='input_31' type='radio' value='nee'  id='choice_23_31_1'    \/>\n\t\t\t\t<label for='choice_23_31_1' id='label_23_31_1' class='gform-field-label gform-field-label--type-inline'>nee<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reisbijstand personen voor duopassagier \u00e0 2 \u20ac\/dag<\/span><\/label><div class='gfield_description' id='gfield_description_23_30'>opmerking: Op dit moment kunnen we deze polis enkel aanbieden voor personen gedomicilieerd in Belgi\u00eb.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_30'>\n\t\t\t<li class='gchoice gchoice_23_30_0'>\n\t\t\t\t<input name='input_30' type='radio' value='ja'  id='choice_23_30_0'    \/>\n\t\t\t\t<label for='choice_23_30_0' id='label_23_30_0' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_30_1'>\n\t\t\t\t<input name='input_30' type='radio' value='nee'  id='choice_23_30_1'    \/>\n\t\t\t\t<label for='choice_23_30_1' id='label_23_30_1' class='gform-field-label gform-field-label--type-inline'>nee<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Algemene voorwaarden<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_32'>\n\t\t\t<li class='gchoice gchoice_23_32_0'>\n\t\t\t\t<input name='input_32' type='radio' value='Ik aanvaard de &lt;a href=&quot;\/algemene-en-bijzondere-voorwaarden\/&quot; target=&quot;blank&quot;&gt;algemene en bijzondere reisvoorwaarden&lt;\/a&gt; van Motorreis.com &amp; D\u00e9tour'  id='choice_23_32_0'    \/>\n\t\t\t\t<label for='choice_23_32_0' id='label_23_32_0' class='gform-field-label gform-field-label--type-inline'>Ik aanvaard de <a href=\"\/algemene-en-bijzondere-voorwaarden\/\" target=\"blank\">algemene en bijzondere reisvoorwaarden<\/a> van Motorreis.com &amp; D\u00e9tour<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Privacy beleid<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_33'>\n\t\t\t<li class='gchoice gchoice_23_33_0'>\n\t\t\t\t<input name='input_33' type='radio' value='Ik heb kennis genomen van de &lt;a href=&quot;\/privacy-policy\/&quot; 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