{"id":1659,"date":"2026-03-15T08:03:08","date_gmt":"2026-03-15T08:03:08","guid":{"rendered":"https:\/\/breuracademy.nl\/?page_id=1659"},"modified":"2026-05-19T19:11:25","modified_gmt":"2026-05-19T19:11:25","slug":"inschrijfformulier","status":"publish","type":"page","link":"https:\/\/breuracademy.nl\/index.php\/inschrijfformulier\/","title":{"rendered":"Inschrijfformulier"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1659\" class=\"elementor elementor-1659\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2d1d2e9 elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"2d1d2e9\" data-element_type=\"section\" data-e-type=\"section\" 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data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">inschrijven<\/h2>\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<div class=\"elementor-element elementor-element-588fe6e e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"588fe6e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-52e0e73 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"52e0e73\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1641-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"1641\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/1659#wpcf7-f1641-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contactformulier\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1641\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1641-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"cf7-veld\">\n\t<p><label>Voornaam *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"voornaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Voornaam\" value=\"\" type=\"text\" name=\"voornaam\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Achternaam *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Achternaam\" value=\"\" type=\"text\" name=\"achternaam\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Geslacht *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"geslacht\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"geslacht\" value=\"Man\" \/><span class=\"wpcf7-list-item-label\">Man<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"geslacht\" value=\"Vrouw\" \/><span class=\"wpcf7-list-item-label\">Vrouw<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Geboortedatum *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"geboortedatum\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"geboortedatum\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>E-mailadres *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"jouw@email.nl\" value=\"\" type=\"email\" name=\"email\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Telefoonnummer *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"telefoonnummer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"06 12345678\" value=\"\" type=\"tel\" name=\"telefoonnummer\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Adres *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Straat en huisnummer\" value=\"\" type=\"text\" name=\"adres\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Postcode en plaats *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postcode_plaats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"1234 AB Plaatsnaam\" value=\"\" type=\"text\" name=\"postcode_plaats\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Les Keuze *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lidmaatschap\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"lidmaatschap\"><option value=\"--- Selecteer keuze ---\">&#8212; Selecteer keuze &#8212;<\/option><option value=\"Jeugd kickboksen (6+ jaar) - 25 EUR p.m.\">Jeugd kickboksen (6+ jaar) &#8211; 25 EUR p.m.<\/option><option value=\"Volwassenen kickboksen - 30 EUR p.m.\">Volwassenen kickboksen &#8211; 30 EUR p.m.<\/option><option value=\"Sportkaart - 0 EUR\">Sportkaart &#8211; 0 EUR<\/option><option value=\"Gelrepas - 0 EUR\">Gelrepas &#8211; 0 EUR<\/option><\/select><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<hr \/>\n<p><em>Vul onderstaande velden alleen in als het lid minderjarig is.<\/em>\n<\/p>\n<div class=\"cf7-veld\">\n\t<p><label>Voornaam ouder\/verzorger<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ouder_voornaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Voornaam ouder\/verzorger\" value=\"\" type=\"text\" name=\"ouder_voornaam\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Achternaam ouder\/verzorger<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ouder_achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Achternaam ouder\/verzorger\" value=\"\" type=\"text\" name=\"ouder_achternaam\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Telefoonnummer ouder\/verzorger<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ouder_telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"06 12345678\" value=\"\" type=\"tel\" name=\"ouder_telefoon\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<hr \/>\n<div class=\"cf7-veld\">\n\t<p><label>Betaling *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"betaling\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"betaling\"><option value=\"--- Selecteer keuze ---\">&#8212; Selecteer keuze &#8212;<\/option><option value=\"Automatische Betaling\">Automatische Betaling<\/option><option value=\"Contant\">Contant<\/option><\/select><\/span><br \/>\n<\/label>\n\t<\/p>\n\t<p><em>We sturen de factuur met betaallink begin van de maand naar je toe.<\/em>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Wil je in onze WhatsApp Groep van Breur Academy (vink dan aan!)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"whatsapp\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"whatsapp[]\" value=\"Ik ga akkoord dat mijn telefoonnummer wordt toegevoegd aan de WhatsApp groep van Breur Academy\" \/><span class=\"wpcf7-list-item-label\">Ik ga akkoord dat mijn telefoonnummer wordt toegevoegd aan de WhatsApp groep van Breur Academy<\/span><\/span><\/span><\/span><br \/>\n<\/label>\n\t<\/p>\n<\/div>\n<div class=\"cf7-veld\">\n\t<p><label>Voorwaarden *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"voorwaarden\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"voorwaarden[]\" value=\"Ik ga akkoord met de voorwaarden van Breur Academy\" \/><span class=\"wpcf7-list-item-label\">Ik ga akkoord met de voorwaarden van Breur 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aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>inschrijven<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","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":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","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 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