{"id":690,"date":"2020-12-03T14:36:41","date_gmt":"2020-12-03T19:36:41","guid":{"rendered":"http:\/\/www.uqac.ca\/cuk\/?page_id=690"},"modified":"2026-02-27T08:32:25","modified_gmt":"2026-02-27T13:32:25","slug":"inscription-en-ligne","status":"publish","type":"page","link":"https:\/\/www.uqac.ca\/cuk\/inscription-en-ligne\/","title":{"rendered":"Paiement en ligne"},"content":{"rendered":"<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_12_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_vp11ve22\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Formulaire de paiement<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"12\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_12\" id=\"frm_hide_fields_12\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"vp11ve22\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_12\" name=\"frm_submit_entry_12\" value=\"c09d5a4ef5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/cuk\/wp-json\/wp\/v2\/pages\/690\" \/><div id=\"frm_field_261_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_nwubdi3\" class=\"frm_primary_label\">Pr\u00e9nom\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_nwubdi3\" name=\"item_meta[261]\" value=\"\"  data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" aria-required=\"true\" data-invmsg=\"Pr\u00e9nom est non valide\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_262_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_last frm_half\">\r\n    <label for=\"field_nnzbxd3\" class=\"frm_primary_label\">Nom de famille\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_nnzbxd3\" name=\"item_meta[262]\" value=\"\"  data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" aria-required=\"true\" data-invmsg=\"Nom de famille est non valide\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_263_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_w4bbu03\" class=\"frm_primary_label\">Adresse courriel\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_w4bbu03\" name=\"item_meta[263]\" value=\"\"  data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" aria-required=\"true\" data-invmsg=\"Adresse courriel est non valide\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_264_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h5>Veuillez s\u00e9lectionner le type de service que vous avez re\u00e7u \u00e0 la Clinique Universitaire de Kin\u00e9siologie :<\/h5>\n<\/div>\n<div id=\"frm_field_265_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\">S\u00e9lectionner le service obtenu\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_265-0\">\t\t\t<label  for=\"field_t5wwn3-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[265]\" id=\"field_t5wwn3-0\" value=\"condition physique 0\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"S\u00e9lectionner le service obtenu est non valide\" aria-invalid=\"false\"  \/> \u00c9valuation de la condition physique (Services inclus: Rencontre initiale, \u00e9valuation, remise de rapport)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_265-3\">\t\t\t<label  for=\"field_t5wwn3-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[265]\" id=\"field_t5wwn3-3\" value=\"suivi 25\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"S\u00e9lectionner le service obtenu est non valide\" aria-invalid=\"false\"  \/> Suivi (25$)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_265-2\">\t\t\t<label  for=\"field_t5wwn3-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[265]\" id=\"field_t5wwn3-2\" value=\"e-lactate 200\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"S\u00e9lectionner le service obtenu est non valide\" aria-invalid=\"false\"  \/> \u00c9valuation Lactate (165 $ + frais d\u2019ouverture de dossier (35$) pour un total de 200$)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_265-1\">\t\t\t<label  for=\"field_t5wwn3-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[265]\" id=\"field_t5wwn3-1\" value=\"Vo2 direct 335\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"S\u00e9lectionner le service obtenu est non valide\" aria-invalid=\"false\"  \/> \u00c9valuation Vo2 max directe (300$ + frais d\u2019ouverture de dossier (35$) pour un total de 335 $)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_265-4\">\t\t\t<label  for=\"field_t5wwn3-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[265]\" id=\"field_t5wwn3-4\" value=\"service personnalise 0\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"S\u00e9lectionner le service obtenu est non valide\" aria-invalid=\"false\"  \/> Service ne figurant pas dans cette liste<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_274_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\">Statut du participant\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_274-0\">\t\t\t<label  for=\"field_n44z8-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[274]\" id=\"field_n44z8-0\" value=\"etudiant 25\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"Statut du participant est non valide\" aria-invalid=\"false\"  \/> \u00c9tudiant(e) (25$)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_274-1\">\t\t\t<label  for=\"field_n44z8-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[274]\" id=\"field_n44z8-1\" value=\"employe 35\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"Statut du participant est non valide\" aria-invalid=\"false\"  \/> Employ\u00e9(e) UQAC (35$)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_274-2\">\t\t\t<label  for=\"field_n44z8-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[274]\" id=\"field_n44z8-2\" value=\"grand public 45\"\n\t\t   data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" data-invmsg=\"Statut du participant est non valide\" aria-invalid=\"false\"  \/> Grand public (45$)<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_266_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <label class=\"frm_primary_label\">Service additionnelle\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_266-1\">\t\t\t<label  for=\"field_45lpgr3-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[266]\" id=\"field_45lpgr3-1\" value=\"eval musculo 90\"\n\t\t   data-invmsg=\"Service additionnelle est non valide\" aria-invalid=\"false\"  \/> \u00c9valuation musculosquelettique (90$)<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_266-3\">\t\t\t<label  for=\"field_45lpgr3-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[266]\" id=\"field_45lpgr3-3\" value=\"entrainement perso 65\"\n\t\t   data-invmsg=\"Service additionnelle est non valide\" aria-invalid=\"false\"  \/> Programme d'entra\u00eenement personnalis\u00e9 (65$)<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_267_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_8b7b2n2\" class=\"frm_primary_label\">Nom du service suppl\u00e9mentaire\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_8b7b2n2\" name=\"item_meta[267]\" value=\"\"  data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" aria-required=\"true\" data-invmsg=\"Nom du service suppl\u00e9mentaire est non valide\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_8b7b2n2\" \/>\r\n    <div id=\"frm_desc_field_8b7b2n2\" class=\"frm_description\">Utiliser cette case si le service re\u00e7u ne figure dans aucune des deux listes pr\u00e9c\u00e9dentes\r\n<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_268_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_he7jll2\" class=\"frm_primary_label\">Prix du service suppl\u00e9mentaire\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_he7jll2\" name=\"item_meta[268]\" value=\"\" style=\"width:125px\" data-reqmsg=\"Ce champ ne peut pas \u00eatre vide\" aria-required=\"true\" data-invmsg=\"Prix du service suppl\u00e9mentaire est non valide\" class=\"auto_width\" aria-invalid=\"false\"   min=\"0\" max=\"500\" step=\"1\" \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_269_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_6zdu1q3\" class=\"frm_primary_label\">Total (non taxable)\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_6zdu1q3\" name=\"item_meta[269]\" value=\"\"  readonly=\"readonly\"  data-invmsg=\"Total (non taxable) est non valide\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<input type=\"hidden\" name=\"item_meta[270]\" id=\"field_9jku8t3-0\" value=\"non\"  data-frmval=\"non\"   \/>\n<input type=\"hidden\" name=\"item_meta[271]\" id=\"field_i7za9p2\" value=\"\" data-frmval=\"\"\/>\n<div id=\"frm_field_272_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n\t<label for=\"g-recaptcha-response\" id=\"field_o7qsv2_label\" class=\"frm_primary_label\">Captcha\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<div  id=\"field_o7qsv2\" class=\"frm-g-recaptcha\" data-sitekey=\"6LfQmdwpAAAAABDLmVtIyNJ8grTo8Dx_lDoYPc4t\" data-size=\"invisible\" data-theme=\"light\"><\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_273_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<input type=\"submit\" value=\"Soumettre\"  class=\"frm_final_submit\" formnovalidate=\"formnovalidate\" \/>\r\n<img decoding=\"async\" class=\"frm_ajax_loading\" src=\"https:\/\/www.uqac.ca\/cuk\/wp-content\/plugins\/formidable\/images\/ajax_loader.gif\" alt=\"Envoi\"\/>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_275_container\">\n\t\t\t<label for=\"field_yhklz\" >\n\t\t\t\tSi vous \u00eates un humain, ne remplissez pas ce champ.\t\t\t<\/label>\n\t\t\t<input  id=\"field_yhklz\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[275]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"70p2gOE3mGsaIM2t7SoFTMoSU8ksPaU3oF8IMq88dZlgsg67oaDPXBucIL38Wjev\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-690","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/pages\/690"}],"collection":[{"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/comments?post=690"}],"version-history":[{"count":5,"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/pages\/690\/revisions"}],"predecessor-version":[{"id":938,"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/pages\/690\/revisions\/938"}],"wp:attachment":[{"href":"https:\/\/www.uqac.ca\/cuk\/wp-json\/wp\/v2\/media?parent=690"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}