{"id":474,"date":"2026-02-19T16:37:46","date_gmt":"2026-02-19T15:37:46","guid":{"rendered":"https:\/\/www.skicare.ch\/form\/"},"modified":"2026-03-03T16:59:27","modified_gmt":"2026-03-03T15:59:27","slug":"form","status":"publish","type":"page","link":"https:\/\/www.skicare.ch\/en\/form\/","title":{"rendered":"Form"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_flex_section et_pb_section_parallax preset--module--divi-section--tmshoaujfo\"><span class=\"et-pb-parallax-wrapper\"><span class=\"et-pb-parallax-background et-pb-parallax-background-module--divi-section-0\" style=\"background-image:url(https:\/\/www.skicare.ch\/wp-content\/uploads\/2026\/02\/1507_IMAGE_01-scaled.webp)\"><\/span><span class=\"et_parallax_gradient\" style=\"background-image:linear-gradient(180deg, rgba(255, 255, 255, 0.2) 11%,#ffffff 100% 100%)\"><\/span><\/span>\n<div class=\"et_pb_row_0 et_pb_row et_flex_row preset--module--divi-row--default\">\n<div class=\"et_pb_column_0 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_0 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--default\"><div class=\"et_pb_text_inner\"><h1>Report an accident<\/h1>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_1 et_pb_section et_section_regular et_flex_section preset--module--divi-section--default\">\n<div class=\"et_pb_row_1 et_pb_row et_flex_row preset--module--divi-row--default\">\n<div class=\"et_pb_column_1 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_code_0 et_pb_code et_pb_module\"><div class=\"et_pb_code_inner\"><script>\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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_1' style='display:none'><style>#gform_wrapper_1[data-form-index=\"0\"].gform-theme{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-btn-bg-color-hover-tertiary: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Report an accident<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/en\/wp-json\/wp\/v2\/pages\/474' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_1_32\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_1_32' class='gfield_label gform-field-label' for='input_1_32'><span class='gform-field-label__text'>LinkedIn<\/span><\/label><div class='ginput_container'><input name='input_32' id='input_1_32' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_1_32'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_1_1\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"223a6f4b\" data-field-span=\"6\"><label id='gfield_label_1_1' class='gfield_label gform-field-label' for='input_1_1'><span class='gform-field-label__text'>Status<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_1_1' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Madam' >Madam<\/option><option value='Sir' >Sir<\/option><\/select><\/div><\/div><div data-field-id=\"1\" class=\"spacer gfield\" style=\"grid-column: span 6;\" data-group-id=\"223a6f4b\"><\/div><fieldset id=\"field_1_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"4c4baa8c\" data-field-span=\"12\"><legend id='gfield_label_1_3' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_3'>\n                            \n                            <span id='input_1_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_3_3' id='input_1_3_3_label' class='gform-field-label gform-field-label--type-sub '>First name<\/label>\n                                                    <input type='text' name='input_3.3' id='input_1_3_3' value=''   aria-required='true'     aria-labelledby=\"input_1_3_3_label gfield_label_1_3\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_3_6' id='input_1_3_6_label' class='gform-field-label gform-field-label--type-sub '>Name<\/label>\n                                                            <input type='text' name='input_3.6' id='input_1_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_4\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"3c7e2b49\" data-field-span=\"12\"><legend id='gfield_label_1_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_1_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_1_4_1_container' >\n                                        <label for='input_1_4_1' id='input_1_4_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                        <input type='text' name='input_4.1' id='input_1_4_1' value=''    aria-required='true'    aria-labelledby=\"input_1_4_1_label gfield_label_1_4\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_1_4_3_container' >\n                                    <label for='input_1_4_3' id='input_1_4_3_label' class='gform-field-label gform-field-label--type-sub '>Postal addressVille<\/label>\n                                    <input type='text' name='input_4.3' id='input_1_4_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_1_4_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_1_4_5_container' >\n                                    <label for='input_1_4_5' id='input_1_4_5_label' class='gform-field-label gform-field-label--type-sub '>Zip code<\/label>\n                                    <input type='text' name='input_4.5' id='input_1_4_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_1_4_6_container' >\n                                        <label for='input_1_4_6' id='input_1_4_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_4.6' id='input_1_4_6'   aria-required='true'    ><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' >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'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'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'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                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_1_5\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"9f5ff7b2\" data-field-span=\"6\"><label id='gfield_label_1_5' class='gfield_label gform-field-label' for='input_1_5'><span class='gform-field-label__text'>Phone<\/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_5' id='input_1_5' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_1_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"9f5ff7b2\" data-field-span=\"6\"><label id='gfield_label_1_6' class='gfield_label gform-field-label' for='input_1_6'><span class='gform-field-label__text'>E-mail<\/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_6' id='input_1_6' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_1_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"ff42d853\" data-field-span=\"12\"><h3 class=\"gsection_title\">Information about the accident<\/h3><\/div><fieldset id=\"field_1_14\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"fd1d4d28\" data-field-span=\"12\"><legend id='gfield_label_1_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name of the accident victim<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_14'>\n                            \n                            <span id='input_1_14_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_14_3' id='input_1_14_3_label' class='gform-field-label gform-field-label--type-sub '>First name<\/label>\n                                                    <input type='text' name='input_14.3' id='input_1_14_3' value=''   aria-required='true'     aria-labelledby=\"input_1_14_3_label gfield_label_1_14\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_14_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_14_6' id='input_1_14_6_label' class='gform-field-label gform-field-label--type-sub '>Name<\/label>\n                                                            <input type='text' name='input_14.6' id='input_1_14_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"aab52cde\" data-field-span=\"12\"><legend id='gfield_label_1_23' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Ajouter une 2\u00e8me personne<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_23'><div class='gchoice gchoice_1_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Ajouter une 2\u00e8me personne'  id='choice_1_23_1'    aria-labelledby=\"label_1_23_1 gfield_label_1_23\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_23_1' id='label_1_23_1' class='gform-field-label gform-field-label--type-inline'>Ajouter une 2\u00e8me personne<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_24\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"8e0cd91e\" data-field-span=\"12\"><legend id='gfield_label_1_24' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom de la 2\u00e8me personne assur\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_24'>\n                            \n                            <span id='input_1_24_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_24_3' id='input_1_24_3_label' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_24.3' id='input_1_24_3' value=''   aria-required='true'     aria-labelledby=\"input_1_24_3_label gfield_label_1_24\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_24_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_24_6' id='input_1_24_6_label' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_24.6' id='input_1_24_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_25\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"92f81dc3\" data-field-span=\"12\"><legend id='gfield_label_1_25' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Ajouter une 3\u00e8me personne<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_25'><div class='gchoice gchoice_1_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='Ajouter une 3\u00e8me personne'  id='choice_1_25_1'    aria-labelledby=\"label_1_25_1 gfield_label_1_25\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_25_1' id='label_1_25_1' class='gform-field-label gform-field-label--type-inline'>Ajouter une 3\u00e8me personne<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_26\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"2b16ab5a\" data-field-span=\"12\"><legend id='gfield_label_1_26' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom de la 3\u00e8me personne assur\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_26'>\n                            \n                            <span id='input_1_26_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_26_3' id='input_1_26_3_label' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_26.3' id='input_1_26_3' value=''   aria-required='true'     aria-labelledby=\"input_1_26_3_label gfield_label_1_26\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_26_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_26_6' id='input_1_26_6_label' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_26.6' id='input_1_26_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"49a930ff\" data-field-span=\"12\"><legend id='gfield_label_1_28' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Ajouter une 4\u00e8me personne<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_28'><div class='gchoice gchoice_1_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Ajouter une 4\u00e8me personne'  id='choice_1_28_1'    aria-labelledby=\"label_1_28_1 gfield_label_1_28\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_28_1' id='label_1_28_1' class='gform-field-label gform-field-label--type-inline'>Ajouter une 4\u00e8me personne<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_29\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"96a2b283\" data-field-span=\"12\"><legend id='gfield_label_1_29' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom de la 4\u00e8me personne assur\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_29'>\n                            \n                            <span id='input_1_29_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_29_3' id='input_1_29_3_label' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_29.3' id='input_1_29_3' value=''   aria-required='true'     aria-labelledby=\"input_1_29_3_label gfield_label_1_29\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_29_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_29_6' id='input_1_29_6_label' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_29.6' id='input_1_29_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"4848b8a9\" data-field-span=\"12\"><legend id='gfield_label_1_30' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Ajouter une 5\u00e8me personne<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_30'><div class='gchoice gchoice_1_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Ajouter une 5\u00e8me personne'  id='choice_1_30_1'    aria-labelledby=\"label_1_30_1 gfield_label_1_30\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_30_1' id='label_1_30_1' class='gform-field-label gform-field-label--type-inline'>Ajouter une 5\u00e8me personne<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_31\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"60a13a34\" data-field-span=\"12\"><legend id='gfield_label_1_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom de la 5\u00e8me personne assur\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_1_31'>\n                            \n                            <span id='input_1_31_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_31_3' id='input_1_31_3_label' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_31.3' id='input_1_31_3' value=''   aria-required='true'     aria-labelledby=\"input_1_31_3_label gfield_label_1_31\"\/>\n                                                <\/span>\n                            \n                            <span id='input_1_31_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_31_6' id='input_1_31_6_label' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_31.6' id='input_1_31_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_1_15\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f85caf38\" data-field-span=\"6\"><label id='gfield_label_1_15' class='gfield_label gform-field-label' for='input_1_15'><span class='gform-field-label__text'>Date of the accident<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_1_15'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_15'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_1_15' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_1_15' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_1_15' aria-label='Date of the accident: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_1_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f85caf38\" data-field-span=\"6\"><label id='gfield_label_1_19' class='gfield_label gform-field-label' for='input_1_19'><span class='gform-field-label__text'>Nature du sinistre<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_1_19' class='large gfield_select'     aria-invalid=\"false\" ><option value='Accident' >Accident<\/option><option value='Maladie' >Maladie<\/option><option value='Mauvais temps' >Mauvais temps<\/option><\/select><\/div><\/div><div id=\"field_1_16\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"5463a60e\" data-field-span=\"12\"><label id='gfield_label_1_16' class='gfield_label gform-field-label' for='input_1_16'><span class='gform-field-label__text'>Circumstances of the accident<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_16'>Describe the victim's accident.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_16' id='input_1_16' class='textarea large'  aria-describedby=\"gfield_description_1_16\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_1_17\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"66d21099\" data-field-span=\"12\"><label id='gfield_label_1_17' class='gfield_label gform-field-label' for='input_1_17'><span class='gform-field-label__text'>Your request<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_1_17' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_1_18\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"29d9e7ef\" data-field-span=\"12\"><label id='gfield_label_1_18' class='gfield_label gform-field-label' for='gform_browse_button_1_18'><span class='gform-field-label__text'>Download your documents<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_18'>For our records, we will ask you to send us a copy of your ski pass, a medical certificate, a statement from your accident insurance, invoices related to the accident, and your bank details.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_1_18' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_1_18&quot;,&quot;container&quot;:&quot;gform_multifile_upload_1_18&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_1_18&quot;,&quot;filelist&quot;:&quot;gform_preview_1_18&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/en\\\/?gf_page=2a5e89ce7ed1d8f&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;104857600b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:1,&quot;field_id&quot;:18,&quot;_gform_file_upload_nonce_1_18&quot;:&quot;845af5582e&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_1_18&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_1_18' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_1_18' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_1_18 gfield_description_1_18\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_1_18'>Max. file size: 100 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_1_18'><\/ul> <div id='gform_preview_1_18' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_1_20\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"505a14ca\" data-field-span=\"12\"><label id='gfield_label_1_20' class='gfield_label gform-field-label' for='gform_browse_button_1_20'><span class='gform-field-label__text'>T\u00e9l\u00e9charger vos documents<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_20'>Pour notre dossier, nous vous demanderons de nous faire parvenir une copie de votre skipass, un certificat m\u00e9dical et vos coordonn\u00e9es bancaires.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_1_20' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_1_20&quot;,&quot;container&quot;:&quot;gform_multifile_upload_1_20&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_1_20&quot;,&quot;filelist&quot;:&quot;gform_preview_1_20&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/en\\\/?gf_page=2a5e89ce7ed1d8f&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;104857600b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:1,&quot;field_id&quot;:20,&quot;_gform_file_upload_nonce_1_20&quot;:&quot;b5c0e6be09&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_1_20&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_1_20' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_1_20' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_1_20 gfield_description_1_20\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_1_20'>Max. file size: 100 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_1_20'><\/ul> <div id='gform_preview_1_20' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_1_21\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"44def7cf\" data-field-span=\"12\"><label id='gfield_label_1_21' class='gfield_label gform-field-label' for='gform_browse_button_1_21'><span class='gform-field-label__text'>T\u00e9l\u00e9charger vos documents<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_1_21'>Pour notre dossier, nous vous demanderons de nous faire parvenir une copie de votre skipass et vos coordonn\u00e9es bancaires.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_1_21' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_1_21&quot;,&quot;container&quot;:&quot;gform_multifile_upload_1_21&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_1_21&quot;,&quot;filelist&quot;:&quot;gform_preview_1_21&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/en\\\/?gf_page=2a5e89ce7ed1d8f&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.skicare.ch\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;104857600b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:1,&quot;field_id&quot;:21,&quot;_gform_file_upload_nonce_1_21&quot;:&quot;b94e72bb87&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_1_21&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_1_21' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_1_21' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_1_21 gfield_description_1_21\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_1_21'>Max. file size: 100 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_1_21'><\/ul> <div id='gform_preview_1_21' class='ginput_preview_list'><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_1' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Send<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_1' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_1' id='gform_theme_1' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_1' id='gform_style_settings_1' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CHF' value='nTiw2B8LrjIWzeQoJ4FVws+HiMeWmhAOPibalhK5xRfZtpDy5dcerAIzJ4pAaiCzRKEp+BZR2zYvFSMu4u9fjEt\/1AVHesPiRMjvVn5FgIo3hVA=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='WyJ7XCIxXCI6W1wiZGVkNzAxNWZkNDQ3NDhhN2JmZmY2ZTZhMTFjNmY3YTVcIixcIjE4NTQ0ZTVkNDg0ZDdkYjUwMTFjZTZlYmQxZTVlMjYxXCJdLFwiMjMuMVwiOlwiMDAwNzUwNDJmMzU4NDA4NjlkMTk1YzU2YTNmN2M5MGRcIixcIjI1LjFcIjpcImI3ZDE2NjJiZjRkZjI3NDA0MGY2MzRkYmM5NmRiNTUzXCIsXCIyOC4xXCI6XCI4ODg1ZjFiMjM0ZDI0OTE3ZmY0ZmM5YzU4NWVhMGFlM1wiLFwiMzAuMVwiOlwiZWM3MGEzZWI4NTZiMGRjZTlhNDIzNTIxOTM1ZjFkMzFcIixcIjE5XCI6W1wiMTM0ZjlhMjg5ZWNhZjE5ZTJiYWQ0MzllYTExNTcyYzhcIixcIjRiM2IxY2FhMDgyYTM2ZTNmYjQ0ZTUwN2FmNWQ4ODZmXCIsXCIwNzY1MjkxZDIwMThjZDU2MTZkOWE2YzkwMjk0YTg3ZFwiXSxcImdmb3JtX3N1Ym1pc3Npb25fbWV0aG9kXCI6W1wiMDgwY2ZiMzY1YmEyOGY0OGY5MTNlYjI0ZjhkMDc0NDNcIixcImY4ODVkNjZkZGMzZWMzMzFlNDRiY2FjZmQwYmYxNzExXCJdLFwiZ2Zvcm1fdGhlbWVcIjpcIjA2OWUyNWY4MTE3NTAzYjU3NTc2ZDQzZTYzYzc2YTc2XCIsXCJnZm9ybV9zdHlsZV9zZXR0aW5nc1wiOlwiYWY5MmY5ZmI4OTM0ODg4MTU4ODFhYWY0MjBlOTRkOTBcIixcImZvcm1faWRcIjpcImVkZmUxM2YyMWU3MDY0YmE5ZWUzNjE2ODRmMDQ0OTFmXCIsXCJ1cmxcIjpcIjY3ZTQzNTZjOGFiMTBkNjM0M2NmMTc4NDQ2MmVlY2QzXCIsXCJzdGF0ZV90aW1lc3RhbXBcIjpcIjhjZDMwODhlYmEyNWVlMTRjNjVhMDRiN2Y1NGI1ZGIyXCJ9IiwiMDMxZmUyYTIzOWM4ZDFjNTA3MzJkM2UwNjMxNGI1ZjgiLDE3OTMwNDY2NjZd' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_1' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-474","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/pages\/474","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/comments?post=474"}],"version-history":[{"count":2,"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/pages\/474\/revisions"}],"predecessor-version":[{"id":476,"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/pages\/474\/revisions\/476"}],"wp:attachment":[{"href":"https:\/\/www.skicare.ch\/en\/wp-json\/wp\/v2\/media?parent=474"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}