{"id":49616,"date":"2026-04-23T17:27:08","date_gmt":"2026-04-23T15:27:08","guid":{"rendered":"https:\/\/nauticescala.com\/?page_id=49616&#038;preview_id=49616"},"modified":"2026-04-23T17:42:32","modified_gmt":"2026-04-23T15:42:32","slug":"formulaire-lesson-prive","status":"publish","type":"page","link":"https:\/\/nauticescala.com\/fr\/formulaire-lesson-prive\/","title":{"rendered":"Formulaire de cours particuliers"},"content":{"rendered":"\t\n\t<section class=\"title-section d-md-block\">\n\t\t<div class=\"container\">\n\t\t\t\t\n\t\t\t\t<h1>Demande de cours particuliers<\/h1>\n\t\t\t\t\t\t\t\n\t\t\t\t<p><h3>Remplissez le formulaire suivant avec les informations de la personne qui r\u00e9alisera l\u2019activit\u00e9.<\/h3><br \/>\r\n<br \/>\r\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f49612-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"49612\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/fr\/wp-json\/wp\/v2\/pages\/49616#wpcf7-f49612-o1\" method=\"post\" class=\"wpcf7-form init cmonitor-ext-0.4.67\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"49612\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f49612-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:49612,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;soci&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;notice_dismissed_rollback-cf7-5.4&quot;:true,&quot;notice_dismissed_update-cf7-5.8&quot;:true,&quot;notice_dismissed_update-cf7-5.8.3&quot;:true,&quot;notice_dismissed_rollback-cf7-5.9.2&quot;:true}}\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"form-body\">\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sender-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"lbl-05\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"sender-name\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-05\">Nom*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sender-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"lbl-07\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"sender-last-name\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">Cognoms*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dni\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">DNI*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dni\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">Data de Naixament*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Adreca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Adreca\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">Adre\u00e7a*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"poblacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"poblacio\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">Poblaci\u00f3*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cp\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"cp\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-07\">Codi Postal*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sender-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email form-control\" id=\"lbl-06\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"sender-email\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-06\">Email*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sender-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel form-control\" id=\"lbl-08\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"sender-phone\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-08\">Tel\u00e8fon*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reason\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required cs\" aria-required=\"true\" aria-invalid=\"false\" name=\"reason\"><option value=\"\">Modalitat*<\/option><option value=\"Rem\">Rem<\/option><option value=\"SUP\">SUP<\/option><option value=\"Caiac\">Caiac<\/option><option value=\"Vela Lleugera\">Vela Lleugera<\/option><option value=\"Creuer\">Creuer<\/option><option value=\"Motora\">Motora<\/option><\/select><\/span>\n<\/div>\n<\/div>\n\n\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data-inici\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" id=\"lbl-10\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"data-inici\" \/><\/span>\n<label class=\"placeholder-label\" for=\"lbl-10\">Data d'inici prevista*<\/label>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"col-md-6\">\n<div class=\"form-group\">\n<div class=\"input-item\">\n<label for=\"lbl-21\">Soci del Club N\u00e0utic<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"soci\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"soci\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"soci\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<\/div>\n<div class=\"form-group form-group-textarea\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"experiencia\"><textarea cols=\"1\" rows=\"1\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control\" id=\"lbl-09\" aria-required=\"true\" aria-invalid=\"false\" name=\"experiencia\"><\/textarea><\/span>\n<label class=\"placeholder-label\" for=\"lbl-09\">Indica'ns la teva experi\u00e8ncia de navegaci\u00f3<\/label>\n<\/div>\n<\/div>\n\n<div class=\"form-group form-group-textarea\">\n<div class=\"input-item\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"1\" rows=\"1\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea form-control\" aria-invalid=\"false\" name=\"message\"><\/textarea><\/span>\n<label class=\"placeholder-label\" for=\"lbl-09\">Indica'ns si tens algun comentari<\/label>\n<\/div>\n<\/div>\n<div class=\"check-block\">\n<label class=\"check-item check-item-md\">\n<span class=\"wpcf7-form-control-wrap\" 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