{"id":2631,"date":"2020-01-03T14:39:07","date_gmt":"2020-01-03T14:39:07","guid":{"rendered":"http:\/\/www.lovecare.pl\/?page_id=2631"},"modified":"2021-04-30T20:39:53","modified_gmt":"2021-04-30T20:39:53","slug":"formularz-zgloszeniowy","status":"publish","type":"page","link":"https:\/\/www.lovecare.pl\/index.php\/formularz-zgloszeniowy\/","title":{"rendered":"Formularz Zg\u0142oszeniowy"},"content":{"rendered":"<h4><strong>Zapisz si\u0119 na jedno z naszych wydarze\u0144<\/strong><\/h4>\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f14571-o1\" lang=\"pl-PL\" dir=\"ltr\">\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\/2631#wpcf7-f14571-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"14571\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.6.2\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f14571-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p><label> Wybierz termin kursu - 5 spotka\u0144 <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"termin_kursu\"><select name=\"termin_kursu\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"04-09-2024\">04-09-2024<\/option><\/select><\/span><\/p>\n<p><label> Imi\u0119 i nazwisko<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imie_nazwisko\"><input type=\"text\" name=\"imie_nazwisko\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p><label> Podstawa do refundacji <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"podstawa_refundacji\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"podstawa_refundacji[]\" value=\"zameldowanie na pobyt sta\u0142y w Warszawie\" \/><span class=\"wpcf7-list-item-label\">zameldowanie na pobyt sta\u0142y w Warszawie<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"podstawa_refundacji[]\" value=\"odprowadzam podatki w Urz\u0119dzie Skarbowym w Warszawie\" \/><span class=\"wpcf7-list-item-label\">odprowadzam podatki w Urz\u0119dzie Skarbowym w Warszawie<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"podstawa_refundacji[]\" value=\"pobyt w warszawskim o\u015brodku pomocy\" \/><span class=\"wpcf7-list-item-label\">pobyt w warszawskim o\u015brodku pomocy<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"podstawa_refundacji[]\" value=\"nie dotyczy\" \/><span class=\"wpcf7-list-item-label\">nie dotyczy<\/span><\/label><\/span><\/span><\/span><\/p>\n<p><label> Termin porodu<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data_porodu\"><input type=\"date\" name=\"data_porodu\" value=\"\" class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p><label>Telefon kontaktowy<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><input type=\"tel\" name=\"telefon\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p><label>Adres email<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input type=\"email\" name=\"email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p><label>Imi\u0119 i nazwisko ojca dziecka, je\u015bli b\u0119dzie uczestniczy\u0142 w zaj\u0119ciach, w przeciwnym wypadku prosz\u0119 wpisa\u0107 \"NIE\"<br \/>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"imie_nazwisko_ojca\"><input type=\"text\" name=\"imie_nazwisko_ojca\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"zgoda_dane\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"zgoda_dane\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Wyra\u017cam zgod\u0119 na przetwarzanie moich danych osobowych zawartych w \u201eKarcie\u201d dla potrzeb niezb\u0119dnych do realizacji Programu Edukacji Przedporodowej \u201eSzko\u0142a Rodzenia\u201d zgodnie z ustaw\u0105 o ochronie danych osobowych w zwi\u0105zku z wys\u0142aniem informacji przez formularz kontaktowy. Podanie danych jest dobrowolne, ale niezb\u0119dne do przetworzenia zam\u00f3wienia. Poinformowano mnie, \u017ce przys\u0142uguje mi prawo dost\u0119pu do swoich danych, mo\u017cliwo\u015bci ich poprawienia, \u017c\u0105dania zaprzestania ich przetwarzania. Administratorem danych jest Lovecare.<\/span><\/label><\/span><\/span><\/span><\/p>\n<p><input type=\"submit\" value=\"Wy\u015blij zg\u0142oszenie\" class=\"wpcf7-form-control has-spinner wpcf7-submit\" \/><\/p>\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"223\"\/><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n\/* ]]> *\/\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Zapisz si\u0119 na jedno z naszych wydarze\u0144<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2631","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/pages\/2631","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/comments?post=2631"}],"version-history":[{"count":13,"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/pages\/2631\/revisions"}],"predecessor-version":[{"id":16442,"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/pages\/2631\/revisions\/16442"}],"wp:attachment":[{"href":"https:\/\/www.lovecare.pl\/index.php\/wp-json\/wp\/v2\/media?parent=2631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}