{"id":6293,"date":"2023-08-10T20:13:40","date_gmt":"2023-08-10T18:13:40","guid":{"rendered":"https:\/\/www.dinamicassd.it\/agonistica\/?page_id=6293"},"modified":"2023-08-11T11:48:56","modified_gmt":"2023-08-11T09:48:56","slug":"modulo-iscrizione","status":"publish","type":"page","link":"https:\/\/www.dinamicassd.it\/agonistica\/modulo-iscrizione\/","title":{"rendered":"Modulo Iscrizione"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.22.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.22.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.22.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.0&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; sticky_enabled=&#8221;0&#8243;]\n<div class=\"um um-register um-6306\">\n\t<div class=\"um-form\" data-mode=\"register\">\n\t\t<form method=\"post\" action=\"\">\n\t\t\t<div class=\"um-row _um_row_1 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_16\"><h1 style=\"text-align: center\">RICHIESTA TESSERAMENTO STAGIONE AGONISTICA 2023-2024<\/h1><\/div><div  id=\"um_field_6306_impianto\" class=\"um-field um-field-radio  um-field-impianto um-field-radio um-field-type_radio\" data-key=\"impianto\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"impianto-6306\">Piscina di<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"impianto[]\" value=\"Chieri\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Chieri<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"impianto[]\" value=\"Susa\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Susa<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_57\">Tutti i campi sono obbligatori.<\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_15\"><p style=\"text-align: center\">Dati dell'ATLETA<\/p><\/div><div  id=\"um_field_6306_first_name\" class=\"um-field um-field-text  um-field-first_name um-field-text um-field-type_text\" data-key=\"first_name\"><div class=\"um-field-label\"><label for=\"first_name-6306\">Nome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"first_name-6306\" id=\"first_name-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"first_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_last_name\" class=\"um-field um-field-text  um-field-last_name um-field-text um-field-type_text\" data-key=\"last_name\"><div class=\"um-field-label\"><label for=\"last_name-6306\">Cognome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"last_name-6306\" id=\"last_name-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"last_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_login\" class=\"um-field um-field-text  um-field-user_login um-field-text um-field-type_text\" data-key=\"user_login\"><div class=\"um-field-label\"><label for=\"user_login-6306\">NomeUtente utilizzato per il login<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_login-6306\" id=\"user_login-6306\" value=\"\" placeholder=\"\" data-validate=\"unique_username\" data-key=\"user_login\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_email\" class=\"um-field um-field-text  um-field-user_email um-field-text um-field-type_text\" data-key=\"user_email\"><div class=\"um-field-label\"><label for=\"user_email-6306\">E-mail<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_email-6306\" id=\"user_email-6306\" value=\"\" placeholder=\"\" data-validate=\"unique_email\" data-key=\"user_email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"user_password\"><div class=\"um-field-label\"><label for=\"user_password-6306\">Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"user_password-6306\" id=\"user_password-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"user_password\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_confirm_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"confirm_user_password\"><div class=\"um-field-label\"><label for=\"confirm_user_password-6306\">Conferma la Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"confirm_user_password-6306\" id=\"confirm_user_password-6306\" value=\"\" placeholder=\"Conferma la Password\" data-validate=\"\" data-key=\"confirm_user_password\"  aria-invalid=\"false\" \/><\/div><\/div><div  id=\"um_field_6306_billing_address_1\" class=\"um-field um-field-text  um-field-billing_address_1 um-field-text um-field-type_text\" data-key=\"billing_address_1\"><div class=\"um-field-label\"><label for=\"billing_address_1-6306\">Indirizzo<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_address_1-6306\" id=\"billing_address_1-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_address_1\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_postcode\" class=\"um-field um-field-text  um-field-billing_postcode um-field-text um-field-type_text\" data-key=\"billing_postcode\"><div class=\"um-field-label\"><label for=\"billing_postcode-6306\">CAP<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_postcode-6306\" id=\"billing_postcode-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_postcode\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_city\" class=\"um-field um-field-text  um-field-billing_city um-field-text um-field-type_text\" data-key=\"billing_city\"><div class=\"um-field-label\"><label for=\"billing_city-6306\">Citt\u00e0<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_city-6306\" id=\"billing_city-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_city\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_country\" class=\"um-field um-field-text  um-field-billing_country um-field-text um-field-type_text\" data-key=\"billing_country\"><div class=\"um-field-label\"><label for=\"billing_country-6306\">Paese<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"billing_country-6306\" id=\"billing_country-6306\" value=\"IT\" placeholder=\"\" data-validate=\"\" data-key=\"billing_country\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_state\" class=\"um-field um-field-text  um-field-billing_state um-field-text um-field-type_text\" data-key=\"billing_state\"><div class=\"um-field-label\"><label for=\"billing_state-6306\">Provincia<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_state-6306\" id=\"billing_state-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_state\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_phone\" class=\"um-field um-field-text  um-field-billing_phone um-field-text um-field-type_text\" data-key=\"billing_phone\"><div class=\"um-field-label\"><label for=\"billing_phone-6306\">Cellulare<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_phone-6306\" id=\"billing_phone-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_phone\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-divider  um-field-divider um-field-type_divider\" data-key=\"um_divider_6306_17\" style=\"border-bottom:4px solid #eeeeee;\"><\/div><div  id=\"um_field_6306_birth_date\" class=\"um-field um-field-date  um-field-birth_date um-field-date um-field-type_date\" data-key=\"birth_date\"><div class=\"um-field-label\"><div class=\"um-field-label-icon\"><i class=\"um-faicon-calendar\" aria-label=\"Data di Nascita\"><\/i><\/div><label for=\"birth_date-6306\">Data di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input   class=\"um-form-field valid um-datepicker \" type=\"text\" name=\"birth_date-6306\" id=\"birth_date-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"birth_date\" data-range=\"years\" data-years=\"115\" data-years_x=\"past\" data-disabled_weekdays=\"\" data-date_min=\"1911,5,23\" data-date_max=\"2026,5,23\" data-format=\"d mmm yyyy\" data-value=\"\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_luogo_nascita\" class=\"um-field um-field-text  um-field-luogo_nascita um-field-text um-field-type_text\" data-key=\"luogo_nascita\"><div class=\"um-field-label\"><label for=\"luogo_nascita-6306\">Luogo di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"luogo_nascita-6306\" id=\"luogo_nascita-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"luogo_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_pr_nascita\" class=\"um-field um-field-text  um-field-pr_nascita um-field-text um-field-type_text\" data-key=\"pr_nascita\"><div class=\"um-field-label\"><label for=\"pr_nascita-6306\">Provincia di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"pr_nascita-6306\" id=\"pr_nascita-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"pr_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_naz_nascita\" class=\"um-field um-field-text  um-field-naz_nascita um-field-text um-field-type_text\" data-key=\"naz_nascita\"><div class=\"um-field-label\"><label for=\"naz_nascita-6306\">Nazione di Nascita<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"naz_nascita-6306\" id=\"naz_nascita-6306\" value=\"IT\" placeholder=\"\" data-validate=\"\" data-key=\"naz_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_c_f\" class=\"um-field um-field-text  um-field-c_f um-field-text um-field-type_text\" data-key=\"c_f\"><div class=\"um-field-label\"><label for=\"c_f-6306\">Codice Fiscale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"c_f-6306\" id=\"c_f-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"c_f\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_professione\" class=\"um-field um-field-text  um-field-professione um-field-text um-field-type_text\" data-key=\"professione\"><div class=\"um-field-label\"><label for=\"professione-6306\">Professione<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"professione-6306\" id=\"professione-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"professione\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div class=\"um-row _um_row_2 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  id=\"um_field_6306_minore\" class=\"um-field um-field-checkbox  um-field-minore um-field-checkbox um-field-type_checkbox\" data-key=\"minore\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"minore-6306\">Da compilare in caso di minore et\u00e0 dell&#039;atleta<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"minore[]\" value=\"Patria Potest\u00e0\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">Patria Potest\u00e0<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_6306_nome-genitore\" class=\"um-field um-field-text  um-is-conditional um-field-nome-genitore um-field-text um-field-type_text\" data-key=\"nome-genitore\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Da compilare in caso di minore et\u00e0 dell&#039;atleta\" data-cond-1-action=\"show\" data-cond-1-field=\"minore\" data-cond-1-operator=\"equals to\" data-cond-1-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"nome-genitore-6306\">Nome del Genitore<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"nome-genitore-6306\" id=\"nome-genitore-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"nome-genitore\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_cognome-genitore\" class=\"um-field um-field-text  um-is-conditional um-field-cognome-genitore um-field-text um-field-type_text\" data-key=\"cognome-genitore\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"cognome-genitore-6306\">Cognome Genitore<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"cognome-genitore-6306\" id=\"cognome-genitore-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"cognome-genitore\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-indirizzo\" class=\"um-field um-field-text  um-is-conditional um-field-g-indirizzo um-field-text um-field-type_text\" data-key=\"g-indirizzo\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-indirizzo-6306\">Indirizzo<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-indirizzo-6306\" id=\"g-indirizzo-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-indirizzo\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-citta\" class=\"um-field um-field-text  um-is-conditional um-field-g-citta um-field-text um-field-type_text\" data-key=\"g-citta\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-citta-6306\">Citt\u00e0<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-citta-6306\" id=\"g-citta-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-citta\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-provincia\" class=\"um-field um-field-text  um-is-conditional um-field-g-provincia um-field-text um-field-type_text\" data-key=\"g-provincia\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-provincia-6306\">Provincia<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-provincia-6306\" id=\"g-provincia-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-provincia\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-cap\" class=\"um-field um-field-text  um-is-conditional um-field-g-cap um-field-text um-field-type_text\" data-key=\"g-cap\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-cap-6306\">CAP<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-cap-6306\" id=\"g-cap-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-cap\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-telegono\" class=\"um-field um-field-text  um-is-conditional um-field-g-telegono um-field-text um-field-type_text\" data-key=\"g-telegono\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-telegono-6306\">Telefono Fisso<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-telegono-6306\" id=\"g-telegono-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-telegono\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-cellulare\" class=\"um-field um-field-text  um-is-conditional um-field-g-cellulare um-field-text um-field-type_text\" data-key=\"g-cellulare\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-cellulare-6306\">Cellulare<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-cellulare-6306\" id=\"g-cellulare-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-cellulare\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-email\" class=\"um-field um-field-text  um-is-conditional um-field-g-email um-field-text um-field-type_text\" data-key=\"g-email\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-email-6306\">Email<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-email-6306\" id=\"g-email-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_23\"><p style=\"text-align: center\">TIPOLOGIA DI TESSERAMENTO RICHIESTO<\/p><\/div><div  id=\"um_field_6306_tipologia\" class=\"um-field um-field-radio  um-field-tipologia um-field-radio um-field-type_radio\" data-key=\"tipologia\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"tipologia[]\" value=\"PROPAGANDA\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">PROPAGANDA<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"tipologia[]\" value=\"AGONISTICA\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">AGONISTICA<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"tipologia[]\" value=\"MASTER\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">MASTER<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_25\"><p style=\"text-align: center\">DISCIPLINA<\/p><\/div><div  id=\"um_field_6306_Disciplina\" class=\"um-field um-field-radio  um-field-Disciplina um-field-radio um-field-type_radio\" data-key=\"Disciplina\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"NUOTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">NUOTO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"PALLANUOTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">PALLANUOTO<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"SALVAMENTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">SALVAMENTO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"FITNESS\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">FITNESS<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"SYNCRO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">SYNCRO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_3 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_28\">DOCUMENTI DA ALLEGARE<\/div><div  id=\"um_field_6306_fototessera\" class=\"um-field um-field-image  um-field-fototessera um-field-image um-field-type_image\" data-key=\"fototessera\" data-mode=\"register\" data-upload-label=\"Carica foto\"><input type=\"hidden\" name=\"fototessera-6306\" id=\"fototessera-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"fototessera-6306\">FOTOTESSERA<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-image-preview \" data-crop=\"0\" data-key=\"fototessera\"><a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a><img decoding=\"async\" class=\"fusion-lazyload-ignore\" src=\"\" alt=\"\" \/><div class=\"um-clear\"><\/div><\/div><a href=\"javascript:void(0);\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> FOTOTESSERA<\/div><div class=\"um-modal-body\"><div class=\"um-single-image-preview \"  data-crop=\"0\" data-ratio=\"1\" data-min_width=\"\" data-min_height=\"\" data-coord=\"\"><a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a><img decoding=\"async\" class=\"fusion-lazyload-ignore\" src=\"\" alt=\"\" \/><div class=\"um-clear\"><\/div><\/div><div class=\"um-clear\"><\/div><div class=\"um-single-image-upload\" data-user_id=\"\" data-nonce=\"6bf6ad840e\" data-timestamp=\"1779563294\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"image\" data-key=\"fototessera\" data-max_size=\"999999999\" data-max_size_error=\"This image is too large!\" data-min_size_error=\"This image is too small!\" data-extension_error=\"Sorry this is not a valid image.\" data-allowed_types=\"png,jpeg,jpg,gif\" data-accept=\"image\/png,image\/jpeg,image\/jpeg,image\/gif\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one image\" data-upload_help_text=\"\">Carica foto<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload image disabled\" data-key=\"fototessera\" data-change=\"Cambia Fotografia\" data-processing=\"Processing...\">Apply<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_ci_fronte\" class=\"um-field um-field-file  um-field-ci_fronte um-field-file um-field-type_file\" data-key=\"ci_fronte\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"ci_fronte-6306\" id=\"ci_fronte-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"ci_fronte-6306\">Copia Carta Identit\u00e0 Fronte<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"ci_fronte\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Carta Identit\u00e0 Fronte<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"ci_fronte\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"ci_fronte\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_ci_fronte_31\" class=\"um-field um-field-file  um-field-ci_fronte_31 um-field-file um-field-type_file\" data-key=\"ci_fronte_31\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"ci_fronte_31-6306\" id=\"ci_fronte_31-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"ci_fronte_31-6306\">Copia Carta Identit\u00e0 Retro<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"ci_fronte_31\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Carta Identit\u00e0 Retro<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"ci_fronte_31\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"ci_fronte_31\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_cf\" class=\"um-field um-field-file  um-field-cf um-field-file um-field-type_file\" data-key=\"cf\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"cf-6306\" id=\"cf-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"cf-6306\">Copia Tessera Sanitaria o Codice Fiscale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"cf\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Tessera Sanitaria o Codice Fiscale<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"cf\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"cf\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_4 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_35\"><h1 style=\"text-align: center\">LIBERATORIA IN ATTESA DEL CERTIFICATO MEDICO:<\/h1>\r\n<p class=\"p1\">PREMESSO CHE l\u2019impianto natatorio \u00e8 gestito dalla \u201cS.S.D. DINAMICA a R.L.\u201d iscritta al REGISTRO NAZIONALE del C.O.N.I. al n\u00b008178130012 e affiliata come scuola nuoto alla FEDERAZIONE ITALIANA NUOTO (F.I.N.) con numero\/codice 196687 nonch\u00e9 affiliata all\u2019 ASSOCIAZIONE CENTRI SPORTIVI ITALIANI (ACSI) con codice 73036.<\/p>\r\n\r\n<ul>\r\n \t<li class=\"li2\">a) Chiedo di essere accolto\/a quale tesserato\/a atleta NON agonista per frequentare le attivit\u00e0 della Piscina;<\/li>\r\n \t<li class=\"li2\">b) Sono stato debitamente informato circa la necessit\u00e0 di produrre certificazione medica attestante la mia idoneit\u00e0 all'esercizio dell'attivit\u00e0 sportiva non agonistica come previsto dal D.M. Balduzzi\/Gnudi del 26\/04\/2013 e successive modifiche che impone il controllo sanitario per la pratica sportiva NON agonistica a coloro che svolgono attivit\u00e0 organizzate dal C.O.N.I., da societ\u00e0 o A.S.D. affiliate alle Federazioni sportive Nazionali o agli Enti di promozione sportiva riconosciuti dal C.O.N.I.;<\/li>\r\n \t<li class=\"li1\">c) Chiedo di essere ammesso a frequentare l\u2019impianto natatorio sin dalla data del presente atto, in attesa della produzione della suddetta certificazione.<\/li>\r\n<\/ul>\r\n<p class=\"p1\">TUTTO CIO' PREMESSO, IO SOTTOSCRITTO, DEBITAMENTE INFORMATO, NEL PIENO POSSESSO DELLE MIE FACOLTA' E SOTTO LA MIA PIENA ED ESCLUSIVA RESPONSABILITA':<\/p>\r\n<p class=\"p1\">1) dichiaro di voler frequentare la piscina dalla data del presente atto pur in assenza di certificazione medica attestante la mia idoneit\u00e0 all'esercizio dell'attivit\u00e0 sportiva non agonistica;<\/p>\r\n<p class=\"p1\">2) dichiaro di sollevare il gestore da ogni qualsiasi responsabilit\u00e0 nei confronti miei e dei miei aventi causa, per danni alla persona e\/o patrimonio che io possa subire frequentando il Centro a causa delle mie condizioni di salute;<\/p>\r\n<p class=\"p1\">3) dichiaro di godere di buona salute e non presentare alcuna controindicazione alla pratica di attivit\u00e0 sportiva non agonistica proposta dalla vostra S.S.D. \u201cDINAMICA\u201d e mi impegno altres\u00ec a consegnare entro la seconda lezione un certificato medico valido (in originale) che attesti tale idoneit\u00e0 alla \u201cS.S.D. DINAMICA a R.L.\u201d pena la non ammissione ai corsi. Inoltre scarico da ogni responsabilit\u00e0 civile e penale la \u201cS.S.D. DINAMICA a R.L.\u201d nel periodo che intercorre tra la data odierna e la consegna del suddetto certificato.<\/p>\r\n<p class=\"p1\">4) prendo atto e riconosco che la presente liberatoria concerne qualsiasi attivit\u00e0 (sportiva &amp; non) da me svolta presso il centro natatorio ivi incluse le attivit\u00e0 che possono presentare accentuata pericolosit\u00e0 (a mero titolo d'esempio, idrobike, acqua fitness, uso attrezzature per il fitness, ovvero sauna).<\/p>\r\n<p class=\"p1\">AI SENSI E PER EFFETTO DELL'ART 1469 bis COD.CIV, LA PRESENTE LIBERATORIA NON SI ESTENDE AD ATTI E\/O OMISSIONI DEL GESTORE DEL CENTRO SPORTIVO E DEL SUO PERSONALE<\/p><\/div><div  id=\"um_field_6306_liberatoria-1\" class=\"um-field um-field-checkbox  um-field-liberatoria-1 um-field-checkbox um-field-type_checkbox\" data-key=\"liberatoria-1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"liberatoria-1[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_5 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_40\"><p class=\"p1\">CONSENSO AL TRATTAMENTO DEI DATI \u2013 ai sensi degli Art.13-14 del Regolamento UE G.D.P.R. 679\/2016 e successive modifiche ed integrazioni.<\/p>\r\n<p class=\"p2\">Presa visione dell\u2019informativa, la cui versione integrale \u00e8 reperibile sul sito (<span class=\"s1\">www.dinamicassd.it<\/span>) e presso la segreteria della piscina che dichiara di conoscere integralmente, dichiaro:<\/p>\r\n<p class=\"p2\">Questa sezione comprende il conferimento di dati particolari: l\u2019eventuale rifiuto comporter\u00e0 l\u2019impossibilit\u00e0 di completare la procedura di tesseramento (rif. Informativa Dinamica Art.2.1)<\/p><\/div><div  id=\"um_field_6306_consenso1\" class=\"um-field um-field-checkbox  um-field-consenso1 um-field-checkbox um-field-type_checkbox\" data-key=\"consenso1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"consenso1[]\" value=\"ESPRIMO IL CONSENSO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ESPRIMO IL CONSENSO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_42\"><p class=\"p1\">Questa sezione comprende il conferimento dei dati particolari a terzi: l\u2019eventuale rifiuto non influir\u00e0 sull\u2019esito della procedura di tesseramento (rif. Informativa Dinamica Art.6.1 )<\/p><\/div><div  id=\"um_field_6306_consenso2\" class=\"um-field um-field-radio  um-field-consenso2 um-field-radio um-field-type_radio\" data-key=\"consenso2\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"consenso2[]\" value=\"ESPRIMO IL CONSENSO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">ESPRIMO IL CONSENSO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"consenso2[]\" value=\"NEGO IL CONSENSO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">NEGO IL CONSENSO<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_6 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_37\"><p class=\"p1\">NORME GENERALI DI CONTRATTO<\/p>\r\n<p class=\"p2\">1. Tutte le formule di abbonamento non possono essere sospese salvo ricoveri ospedalieri e malattie esantematiche. In tali casi si dovr\u00e0 portare in segreteria un certificato medico che attesti il fatto: la sospensione non pu\u00f2 essere retroattiva e l\u2019utente sospeso viene escluso dai corsi che frequentava. Per riaccedervi dovr\u00e0 ripetere la procedura di prenotazione del corso stesso. La sospensione avr\u00e0 durata pari ai giorni di prognosi indicati sul certificato medico, fatti salvi eventuali prolungamenti, sempre certificati.<\/p>\r\n<p class=\"p2\">2. La propria tessera d\u2019iscrizione e l\u2019abbonamento sottoscritti non sono cedibili n\u00e9 rimborsabili.<\/p>\r\n<p class=\"p2\">3. Con la presente dichiaro inoltre di aver preso visione, presso la segreteria della piscina, del regolamento dell\u2019impianto e di accettarlo in tutte le sue parti.<\/p>\r\n<p class=\"p2\">4. Fornisco il consenso alla Societ\u00e0 \u201cDINAMICA SSD a R.L.\u201d ad utilizzare eventuali immagini e\/o registrazioni video effettuate durante lo svolgimento dell\u2019attivit\u00e0; inoltre autorizzo la divulgazione con qualsivoglia mezzo tecnico o tipologia di trasmissione esistente o di futura invenzione (a titolo esemplificativo: via etere, cavo, satellite di ogni genere e tipo, mmds, ecc.) senza limitazioni di spazio, di tempo e di passaggi nell\u2019ambito della propria attivit\u00e0 e senza ricevere compenso in qualsiasi sede, forma e modo.<\/p>\r\n<p class=\"p3\">5. Dichiaro altres\u00ec di assumermi tutte le responsabilit\u00e0 in caso di danni a cose e persone riconducibili a una mia negligenza durante lo svolgimento dell\u2019attivit\u00e0 fitness\/giochi e di risarcire pertanto la Societ\u00e0 in caso di danni ai materiali forniti.<\/p><\/div><div  id=\"um_field_6306_norme-1\" class=\"um-field um-field-checkbox  um-field-norme-1 um-field-checkbox um-field-type_checkbox\" data-key=\"norme-1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"norme-1[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_55\">Accetto il codice etico che ho visionato all'indirizzo <a href=\"https:\/\/www.dinamicassd.it\/agonistica\/codice-etico\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.dinamicassd.it\/agonistica\/codice-etico\/<\/a><\/div><div  id=\"um_field_6306_cetico\" class=\"um-field um-field-checkbox  um-field-cetico um-field-checkbox um-field-type_checkbox\" data-key=\"cetico\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"cetico-6306\">Codice Etico<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"cetico[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div>\t<input type=\"hidden\" name=\"form_id\" id=\"form_id_6306\" value=\"6306\" \/>\n\t\t<p class=\"um_request_name\">\n\t\t<label for=\"um_request_6306\">Only fill in if you are not human<\/label>\n\t\t<input type=\"hidden\" name=\"um_request\" id=\"um_request_6306\" class=\"input\" value=\"\" size=\"25\" autocomplete=\"off\" \/>\n\t<\/p>\n\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"5a90bc7e90\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/agonistica\/wp-json\/wp\/v2\/pages\/6293\" \/>\n\t<div class=\"um-col-alt\">\n\n\t\t\n\t\t\t<div class=\"um-left um-half\">\n\t\t\t\t<input type=\"submit\" value=\"Registrati\" class=\"um-button\" id=\"um-submit-btn\" \/>\n\t\t\t<\/div>\n\t\t\t<div class=\"um-right um-half\">\n\t\t\t\t<a href=\"https:\/\/www.dinamicassd.it\/agonistica\/login\/\" class=\"um-button um-alt\">\n\t\t\t\t\tLogin\t\t\t\t<\/a>\n\t\t\t<\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\n\t<\/div>\n\n\t\t\t<\/form>\n\t<\/div>\n<\/div>\n<style>\n\t\t\t.um-6306.um {\n\t\t\tmax-width: 800px;\n\t\t}\n\t\t<\/style>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"\n<div class=\"um um-register um-6306\">\n\t<div class=\"um-form\" data-mode=\"register\">\n\t\t<form method=\"post\" action=\"\">\n\t\t\t<div class=\"um-row _um_row_1 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_16\"><h1 style=\"text-align: center\">RICHIESTA TESSERAMENTO STAGIONE AGONISTICA 2023-2024<\/h1><\/div><div  id=\"um_field_6306_impianto\" class=\"um-field um-field-radio  um-field-impianto um-field-radio um-field-type_radio\" data-key=\"impianto\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"impianto-6306\">Piscina di<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"impianto[]\" value=\"Chieri\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Chieri<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"impianto[]\" value=\"Susa\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Susa<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_57\">Tutti i campi sono obbligatori.<\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_15\"><p style=\"text-align: center\">Dati dell'ATLETA<\/p><\/div><div  id=\"um_field_6306_first_name\" class=\"um-field um-field-text  um-field-first_name um-field-text um-field-type_text\" data-key=\"first_name\"><div class=\"um-field-label\"><label for=\"first_name-6306\">Nome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"first_name-6306\" id=\"first_name-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"first_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_last_name\" class=\"um-field um-field-text  um-field-last_name um-field-text um-field-type_text\" data-key=\"last_name\"><div class=\"um-field-label\"><label for=\"last_name-6306\">Cognome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"last_name-6306\" id=\"last_name-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"last_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_login\" class=\"um-field um-field-text  um-field-user_login um-field-text um-field-type_text\" data-key=\"user_login\"><div class=\"um-field-label\"><label for=\"user_login-6306\">NomeUtente utilizzato per il login<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_login-6306\" id=\"user_login-6306\" value=\"\" placeholder=\"\" data-validate=\"unique_username\" data-key=\"user_login\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_email\" class=\"um-field um-field-text  um-field-user_email um-field-text um-field-type_text\" data-key=\"user_email\"><div class=\"um-field-label\"><label for=\"user_email-6306\">E-mail<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_email-6306\" id=\"user_email-6306\" value=\"\" placeholder=\"\" data-validate=\"unique_email\" data-key=\"user_email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"user_password\"><div class=\"um-field-label\"><label for=\"user_password-6306\">Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"user_password-6306\" id=\"user_password-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"user_password\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_confirm_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"confirm_user_password\"><div class=\"um-field-label\"><label for=\"confirm_user_password-6306\">Conferma la Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"confirm_user_password-6306\" id=\"confirm_user_password-6306\" value=\"\" placeholder=\"Conferma la Password\" data-validate=\"\" data-key=\"confirm_user_password\"  aria-invalid=\"false\" \/><\/div><\/div><div  id=\"um_field_6306_billing_address_1\" class=\"um-field um-field-text  um-field-billing_address_1 um-field-text um-field-type_text\" data-key=\"billing_address_1\"><div class=\"um-field-label\"><label for=\"billing_address_1-6306\">Indirizzo<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_address_1-6306\" id=\"billing_address_1-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_address_1\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_postcode\" class=\"um-field um-field-text  um-field-billing_postcode um-field-text um-field-type_text\" data-key=\"billing_postcode\"><div class=\"um-field-label\"><label for=\"billing_postcode-6306\">CAP<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_postcode-6306\" id=\"billing_postcode-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_postcode\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_city\" class=\"um-field um-field-text  um-field-billing_city um-field-text um-field-type_text\" data-key=\"billing_city\"><div class=\"um-field-label\"><label for=\"billing_city-6306\">Citt\u00e0<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_city-6306\" id=\"billing_city-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_city\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_country\" class=\"um-field um-field-text  um-field-billing_country um-field-text um-field-type_text\" data-key=\"billing_country\"><div class=\"um-field-label\"><label for=\"billing_country-6306\">Paese<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"billing_country-6306\" id=\"billing_country-6306\" value=\"IT\" placeholder=\"\" data-validate=\"\" data-key=\"billing_country\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_state\" class=\"um-field um-field-text  um-field-billing_state um-field-text um-field-type_text\" data-key=\"billing_state\"><div class=\"um-field-label\"><label for=\"billing_state-6306\">Provincia<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_state-6306\" id=\"billing_state-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_state\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_billing_phone\" class=\"um-field um-field-text  um-field-billing_phone um-field-text um-field-type_text\" data-key=\"billing_phone\"><div class=\"um-field-label\"><label for=\"billing_phone-6306\">Cellulare<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"billing_phone-6306\" id=\"billing_phone-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"billing_phone\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-divider  um-field-divider um-field-type_divider\" data-key=\"um_divider_6306_17\" style=\"border-bottom:4px solid #eeeeee;\"><\/div><div  id=\"um_field_6306_birth_date\" class=\"um-field um-field-date  um-field-birth_date um-field-date um-field-type_date\" data-key=\"birth_date\"><div class=\"um-field-label\"><div class=\"um-field-label-icon\"><i class=\"um-faicon-calendar\" aria-label=\"Data di Nascita\"><\/i><\/div><label for=\"birth_date-6306\">Data di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input   class=\"um-form-field valid um-datepicker \" type=\"text\" name=\"birth_date-6306\" id=\"birth_date-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"birth_date\" data-range=\"years\" data-years=\"115\" data-years_x=\"past\" data-disabled_weekdays=\"\" data-date_min=\"1911,5,23\" data-date_max=\"2026,5,23\" data-format=\"d mmm yyyy\" data-value=\"\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_luogo_nascita\" class=\"um-field um-field-text  um-field-luogo_nascita um-field-text um-field-type_text\" data-key=\"luogo_nascita\"><div class=\"um-field-label\"><label for=\"luogo_nascita-6306\">Luogo di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"luogo_nascita-6306\" id=\"luogo_nascita-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"luogo_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_pr_nascita\" class=\"um-field um-field-text  um-field-pr_nascita um-field-text um-field-type_text\" data-key=\"pr_nascita\"><div class=\"um-field-label\"><label for=\"pr_nascita-6306\">Provincia di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"pr_nascita-6306\" id=\"pr_nascita-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"pr_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_naz_nascita\" class=\"um-field um-field-text  um-field-naz_nascita um-field-text um-field-type_text\" data-key=\"naz_nascita\"><div class=\"um-field-label\"><label for=\"naz_nascita-6306\">Nazione di Nascita<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"naz_nascita-6306\" id=\"naz_nascita-6306\" value=\"IT\" placeholder=\"\" data-validate=\"\" data-key=\"naz_nascita\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_c_f\" class=\"um-field um-field-text  um-field-c_f um-field-text um-field-type_text\" data-key=\"c_f\"><div class=\"um-field-label\"><label for=\"c_f-6306\">Codice Fiscale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"c_f-6306\" id=\"c_f-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"c_f\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_professione\" class=\"um-field um-field-text  um-field-professione um-field-text um-field-type_text\" data-key=\"professione\"><div class=\"um-field-label\"><label for=\"professione-6306\">Professione<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"professione-6306\" id=\"professione-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"professione\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div class=\"um-row _um_row_2 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  id=\"um_field_6306_minore\" class=\"um-field um-field-checkbox  um-field-minore um-field-checkbox um-field-type_checkbox\" data-key=\"minore\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"minore-6306\">Da compilare in caso di minore et\u00e0 dell&#039;atleta<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"minore[]\" value=\"Patria Potest\u00e0\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">Patria Potest\u00e0<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_6306_nome-genitore\" class=\"um-field um-field-text  um-is-conditional um-field-nome-genitore um-field-text um-field-type_text\" data-key=\"nome-genitore\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Da compilare in caso di minore et\u00e0 dell&#039;atleta\" data-cond-1-action=\"show\" data-cond-1-field=\"minore\" data-cond-1-operator=\"equals to\" data-cond-1-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"nome-genitore-6306\">Nome del Genitore<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"nome-genitore-6306\" id=\"nome-genitore-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"nome-genitore\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_cognome-genitore\" class=\"um-field um-field-text  um-is-conditional um-field-cognome-genitore um-field-text um-field-type_text\" data-key=\"cognome-genitore\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"cognome-genitore-6306\">Cognome Genitore<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"cognome-genitore-6306\" id=\"cognome-genitore-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"cognome-genitore\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-indirizzo\" class=\"um-field um-field-text  um-is-conditional um-field-g-indirizzo um-field-text um-field-type_text\" data-key=\"g-indirizzo\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-indirizzo-6306\">Indirizzo<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-indirizzo-6306\" id=\"g-indirizzo-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-indirizzo\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-citta\" class=\"um-field um-field-text  um-is-conditional um-field-g-citta um-field-text um-field-type_text\" data-key=\"g-citta\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-citta-6306\">Citt\u00e0<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-citta-6306\" id=\"g-citta-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-citta\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-provincia\" class=\"um-field um-field-text  um-is-conditional um-field-g-provincia um-field-text um-field-type_text\" data-key=\"g-provincia\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-provincia-6306\">Provincia<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-provincia-6306\" id=\"g-provincia-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-provincia\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-cap\" class=\"um-field um-field-text  um-is-conditional um-field-g-cap um-field-text um-field-type_text\" data-key=\"g-cap\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-cap-6306\">CAP<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-cap-6306\" id=\"g-cap-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-cap\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-telegono\" class=\"um-field um-field-text  um-is-conditional um-field-g-telegono um-field-text um-field-type_text\" data-key=\"g-telegono\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-telegono-6306\">Telefono Fisso<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-telegono-6306\" id=\"g-telegono-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-telegono\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-cellulare\" class=\"um-field um-field-text  um-is-conditional um-field-g-cellulare um-field-text um-field-type_text\" data-key=\"g-cellulare\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-cellulare-6306\">Cellulare<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-cellulare-6306\" id=\"g-cellulare-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-cellulare\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_6306_g-email\" class=\"um-field um-field-text  um-is-conditional um-field-g-email um-field-text um-field-type_text\" data-key=\"g-email\" data-cond-0-action=\"show\" data-cond-0-field=\"minore\" data-cond-0-operator=\"equals to\" data-cond-0-value=\"Patria Potest\u00e0\"><div class=\"um-field-label\"><label for=\"g-email-6306\">Email<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"g-email-6306\" id=\"g-email-6306\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"g-email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_23\"><p style=\"text-align: center\">TIPOLOGIA DI TESSERAMENTO RICHIESTO<\/p><\/div><div  id=\"um_field_6306_tipologia\" class=\"um-field um-field-radio  um-field-tipologia um-field-radio um-field-type_radio\" data-key=\"tipologia\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"tipologia[]\" value=\"PROPAGANDA\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">PROPAGANDA<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"tipologia[]\" value=\"AGONISTICA\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">AGONISTICA<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"tipologia[]\" value=\"MASTER\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">MASTER<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_25\"><p style=\"text-align: center\">DISCIPLINA<\/p><\/div><div  id=\"um_field_6306_Disciplina\" class=\"um-field um-field-radio  um-field-Disciplina um-field-radio um-field-type_radio\" data-key=\"Disciplina\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"NUOTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">NUOTO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"PALLANUOTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">PALLANUOTO<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"SALVAMENTO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">SALVAMENTO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"FITNESS\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">FITNESS<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"Disciplina[]\" value=\"SYNCRO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">SYNCRO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_3 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_28\">DOCUMENTI DA ALLEGARE<\/div><div  id=\"um_field_6306_fototessera\" class=\"um-field um-field-image  um-field-fototessera um-field-image um-field-type_image\" data-key=\"fototessera\" data-mode=\"register\" data-upload-label=\"Carica foto\"><input type=\"hidden\" name=\"fototessera-6306\" id=\"fototessera-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"fototessera-6306\">FOTOTESSERA<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-image-preview \" data-crop=\"0\" data-key=\"fototessera\"><a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a><img decoding=\"async\" class=\"fusion-lazyload-ignore\" src=\"\" alt=\"\" \/><div class=\"um-clear\"><\/div><\/div><a href=\"javascript:void(0);\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> FOTOTESSERA<\/div><div class=\"um-modal-body\"><div class=\"um-single-image-preview \"  data-crop=\"0\" data-ratio=\"1\" data-min_width=\"\" data-min_height=\"\" data-coord=\"\"><a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a><img decoding=\"async\" class=\"fusion-lazyload-ignore\" src=\"\" alt=\"\" \/><div class=\"um-clear\"><\/div><\/div><div class=\"um-clear\"><\/div><div class=\"um-single-image-upload\" data-user_id=\"\" data-nonce=\"6bf6ad840e\" data-timestamp=\"1779563294\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"image\" data-key=\"fototessera\" data-max_size=\"999999999\" data-max_size_error=\"This image is too large!\" data-min_size_error=\"This image is too small!\" data-extension_error=\"Sorry this is not a valid image.\" data-allowed_types=\"png,jpeg,jpg,gif\" data-accept=\"image\/png,image\/jpeg,image\/jpeg,image\/gif\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one image\" data-upload_help_text=\"\">Carica foto<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload image disabled\" data-key=\"fototessera\" data-change=\"Cambia Fotografia\" data-processing=\"Processing...\">Apply<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_ci_fronte\" class=\"um-field um-field-file  um-field-ci_fronte um-field-file um-field-type_file\" data-key=\"ci_fronte\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"ci_fronte-6306\" id=\"ci_fronte-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"ci_fronte-6306\">Copia Carta Identit\u00e0 Fronte<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"ci_fronte\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Carta Identit\u00e0 Fronte<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"ci_fronte\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"ci_fronte\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_ci_fronte_31\" class=\"um-field um-field-file  um-field-ci_fronte_31 um-field-file um-field-type_file\" data-key=\"ci_fronte_31\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"ci_fronte_31-6306\" id=\"ci_fronte_31-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"ci_fronte_31-6306\">Copia Carta Identit\u00e0 Retro<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"ci_fronte_31\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Carta Identit\u00e0 Retro<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"ci_fronte_31\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"ci_fronte_31\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div  id=\"um_field_6306_cf\" class=\"um-field um-field-file  um-field-cf um-field-file um-field-type_file\" data-key=\"cf\" data-mode=\"register\" data-upload-label=\"Carica foto o scansione\"><input type=\"hidden\" name=\"cf-6306\" id=\"cf-6306\" value=\"\"  aria-invalid=\"false\" \/><div class=\"um-field-label\"><label for=\"cf-6306\">Copia Tessera Sanitaria o Codice Fiscale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\" style=\"text-align: center;\"><div class=\"um-single-file-preview\" data-key=\"cf\"><\/div><a href=\"#\" data-modal=\"um_upload_single\" data-modal-size=\"normal\" data-modal-copy=\"1\" class=\"um-button um-btn-auto-width\">Carica foto o scansione<\/a><\/div><div class=\"um-modal-hidden-content\"><div class=\"um-modal-header\"> Copia Tessera Sanitaria o Codice Fiscale<\/div><div class=\"um-modal-body\"><div class=\"um-single-file-preview\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"cancel\"><i class=\"um-icon-close\"><\/i><\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"um-single-fileinfo\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\" target=\"_blank\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"icon\"><i><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"filename\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div><div class=\"um-single-file-upload\" data-user_id=\"\" data-timestamp=\"1779563294\" data-nonce=\"6bf6ad840e\"  data-set_id=\"6306\" data-set_mode=\"register\" data-type=\"file\" data-key=\"cf\" data-max_size=\"999999999\" data-max_size_error=\"This file is too large!\" data-min_size_error=\"This file is too small!\" data-extension_error=\"Sorry this is not a valid file.\" data-allowed_types=\"pdf,txt,doc,docx,odt,ods,jpg,jpeg,png,gif,tif,tiff\" data-accept=\"application\/pdf,text\/plain,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.spreadsheet,image\/jpeg,image\/jpeg,image\/png,image\/gif,image\/tiff,image\/tiff\" data-upload_text=\"Trascina il file qui\" data-max_files_error=\"You can only upload one file\" data-upload_help_text=\"\">Carica foto o scansione<\/div><div class=\"um-modal-footer\">\n\t\t\t\t\t\t\t\t\t<div class=\"um-modal-right\">\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn um-finish-upload file disabled\" data-key=\"cf\" data-change=\"Cambia Documento\" data-processing=\"Processing...\"> Salva<\/a>\n\t\t\t\t\t\t\t\t\t\t<a href=\"javascript:void(0);\" class=\"um-modal-btn alt\" data-action=\"um_remove_modal\"> Annulla<\/a>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"um-clear\"><\/div>\n\t\t\t\t\t\t\t\t<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_4 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_35\"><h1 style=\"text-align: center\">LIBERATORIA IN ATTESA DEL CERTIFICATO MEDICO:<\/h1>\r\n<p class=\"p1\">PREMESSO CHE l\u2019impianto natatorio \u00e8 gestito dalla \u201cS.S.D. DINAMICA a R.L.\u201d iscritta al REGISTRO NAZIONALE del C.O.N.I. al n\u00b008178130012 e affiliata come scuola nuoto alla FEDERAZIONE ITALIANA NUOTO (F.I.N.) con numero\/codice 196687 nonch\u00e9 affiliata all\u2019 ASSOCIAZIONE CENTRI SPORTIVI ITALIANI (ACSI) con codice 73036.<\/p>\r\n\r\n<ul>\r\n \t<li class=\"li2\">a) Chiedo di essere accolto\/a quale tesserato\/a atleta NON agonista per frequentare le attivit\u00e0 della Piscina;<\/li>\r\n \t<li class=\"li2\">b) Sono stato debitamente informato circa la necessit\u00e0 di produrre certificazione medica attestante la mia idoneit\u00e0 all'esercizio dell'attivit\u00e0 sportiva non agonistica come previsto dal D.M. Balduzzi\/Gnudi del 26\/04\/2013 e successive modifiche che impone il controllo sanitario per la pratica sportiva NON agonistica a coloro che svolgono attivit\u00e0 organizzate dal C.O.N.I., da societ\u00e0 o A.S.D. affiliate alle Federazioni sportive Nazionali o agli Enti di promozione sportiva riconosciuti dal C.O.N.I.;<\/li>\r\n \t<li class=\"li1\">c) Chiedo di essere ammesso a frequentare l\u2019impianto natatorio sin dalla data del presente atto, in attesa della produzione della suddetta certificazione.<\/li>\r\n<\/ul>\r\n<p class=\"p1\">TUTTO CIO' PREMESSO, IO SOTTOSCRITTO, DEBITAMENTE INFORMATO, NEL PIENO POSSESSO DELLE MIE FACOLTA' E SOTTO LA MIA PIENA ED ESCLUSIVA RESPONSABILITA':<\/p>\r\n<p class=\"p1\">1) dichiaro di voler frequentare la piscina dalla data del presente atto pur in assenza di certificazione medica attestante la mia idoneit\u00e0 all'esercizio dell'attivit\u00e0 sportiva non agonistica;<\/p>\r\n<p class=\"p1\">2) dichiaro di sollevare il gestore da ogni qualsiasi responsabilit\u00e0 nei confronti miei e dei miei aventi causa, per danni alla persona e\/o patrimonio che io possa subire frequentando il Centro a causa delle mie condizioni di salute;<\/p>\r\n<p class=\"p1\">3) dichiaro di godere di buona salute e non presentare alcuna controindicazione alla pratica di attivit\u00e0 sportiva non agonistica proposta dalla vostra S.S.D. \u201cDINAMICA\u201d e mi impegno altres\u00ec a consegnare entro la seconda lezione un certificato medico valido (in originale) che attesti tale idoneit\u00e0 alla \u201cS.S.D. DINAMICA a R.L.\u201d pena la non ammissione ai corsi. Inoltre scarico da ogni responsabilit\u00e0 civile e penale la \u201cS.S.D. DINAMICA a R.L.\u201d nel periodo che intercorre tra la data odierna e la consegna del suddetto certificato.<\/p>\r\n<p class=\"p1\">4) prendo atto e riconosco che la presente liberatoria concerne qualsiasi attivit\u00e0 (sportiva &amp; non) da me svolta presso il centro natatorio ivi incluse le attivit\u00e0 che possono presentare accentuata pericolosit\u00e0 (a mero titolo d'esempio, idrobike, acqua fitness, uso attrezzature per il fitness, ovvero sauna).<\/p>\r\n<p class=\"p1\">AI SENSI E PER EFFETTO DELL'ART 1469 bis COD.CIV, LA PRESENTE LIBERATORIA NON SI ESTENDE AD ATTI E\/O OMISSIONI DEL GESTORE DEL CENTRO SPORTIVO E DEL SUO PERSONALE<\/p><\/div><div  id=\"um_field_6306_liberatoria-1\" class=\"um-field um-field-checkbox  um-field-liberatoria-1 um-field-checkbox um-field-type_checkbox\" data-key=\"liberatoria-1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"liberatoria-1[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_5 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_40\"><p class=\"p1\">CONSENSO AL TRATTAMENTO DEI DATI \u2013 ai sensi degli Art.13-14 del Regolamento UE G.D.P.R. 679\/2016 e successive modifiche ed integrazioni.<\/p>\r\n<p class=\"p2\">Presa visione dell\u2019informativa, la cui versione integrale \u00e8 reperibile sul sito (<span class=\"s1\">www.dinamicassd.it<\/span>) e presso la segreteria della piscina che dichiara di conoscere integralmente, dichiaro:<\/p>\r\n<p class=\"p2\">Questa sezione comprende il conferimento di dati particolari: l\u2019eventuale rifiuto comporter\u00e0 l\u2019impossibilit\u00e0 di completare la procedura di tesseramento (rif. Informativa Dinamica Art.2.1)<\/p><\/div><div  id=\"um_field_6306_consenso1\" class=\"um-field um-field-checkbox  um-field-consenso1 um-field-checkbox um-field-type_checkbox\" data-key=\"consenso1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"consenso1[]\" value=\"ESPRIMO IL CONSENSO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ESPRIMO IL CONSENSO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_42\"><p class=\"p1\">Questa sezione comprende il conferimento dei dati particolari a terzi: l\u2019eventuale rifiuto non influir\u00e0 sull\u2019esito della procedura di tesseramento (rif. Informativa Dinamica Art.6.1 )<\/p><\/div><div  id=\"um_field_6306_consenso2\" class=\"um-field um-field-radio  um-field-consenso2 um-field-radio um-field-type_radio\" data-key=\"consenso2\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"consenso2[]\" value=\"ESPRIMO IL CONSENSO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">ESPRIMO IL CONSENSO<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"consenso2[]\" value=\"NEGO IL CONSENSO\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">NEGO IL CONSENSO<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_6 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_37\"><p class=\"p1\">NORME GENERALI DI CONTRATTO<\/p>\r\n<p class=\"p2\">1. Tutte le formule di abbonamento non possono essere sospese salvo ricoveri ospedalieri e malattie esantematiche. In tali casi si dovr\u00e0 portare in segreteria un certificato medico che attesti il fatto: la sospensione non pu\u00f2 essere retroattiva e l\u2019utente sospeso viene escluso dai corsi che frequentava. Per riaccedervi dovr\u00e0 ripetere la procedura di prenotazione del corso stesso. La sospensione avr\u00e0 durata pari ai giorni di prognosi indicati sul certificato medico, fatti salvi eventuali prolungamenti, sempre certificati.<\/p>\r\n<p class=\"p2\">2. La propria tessera d\u2019iscrizione e l\u2019abbonamento sottoscritti non sono cedibili n\u00e9 rimborsabili.<\/p>\r\n<p class=\"p2\">3. Con la presente dichiaro inoltre di aver preso visione, presso la segreteria della piscina, del regolamento dell\u2019impianto e di accettarlo in tutte le sue parti.<\/p>\r\n<p class=\"p2\">4. Fornisco il consenso alla Societ\u00e0 \u201cDINAMICA SSD a R.L.\u201d ad utilizzare eventuali immagini e\/o registrazioni video effettuate durante lo svolgimento dell\u2019attivit\u00e0; inoltre autorizzo la divulgazione con qualsivoglia mezzo tecnico o tipologia di trasmissione esistente o di futura invenzione (a titolo esemplificativo: via etere, cavo, satellite di ogni genere e tipo, mmds, ecc.) senza limitazioni di spazio, di tempo e di passaggi nell\u2019ambito della propria attivit\u00e0 e senza ricevere compenso in qualsiasi sede, forma e modo.<\/p>\r\n<p class=\"p3\">5. Dichiaro altres\u00ec di assumermi tutte le responsabilit\u00e0 in caso di danni a cose e persone riconducibili a una mia negligenza durante lo svolgimento dell\u2019attivit\u00e0 fitness\/giochi e di risarcire pertanto la Societ\u00e0 in caso di danni ai materiali forniti.<\/p><\/div><div  id=\"um_field_6306_norme-1\" class=\"um-field um-field-checkbox  um-field-norme-1 um-field-checkbox um-field-type_checkbox\" data-key=\"norme-1\"  aria-invalid=\"false\" ><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"norme-1[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_6306_55\">Accetto il codice etico che ho visionato all'indirizzo <a href=\"https:\/\/www.dinamicassd.it\/agonistica\/codice-etico\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.dinamicassd.it\/agonistica\/codice-etico\/<\/a><\/div><div  id=\"um_field_6306_cetico\" class=\"um-field um-field-checkbox  um-field-cetico um-field-checkbox um-field-type_checkbox\" data-key=\"cetico\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"cetico-6306\">Codice Etico<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"cetico[]\" value=\"ACCETTO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">ACCETTO<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><\/div><\/div>\t<input type=\"hidden\" name=\"form_id\" id=\"form_id_6306\" value=\"6306\" \/>\n\t\t<p class=\"um_request_name\">\n\t\t<label for=\"um_request_6306\">Only fill in if you are not human<\/label>\n\t\t<input type=\"hidden\" name=\"um_request\" id=\"um_request_6306\" class=\"input\" value=\"\" size=\"25\" autocomplete=\"off\" \/>\n\t<\/p>\n\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"5a90bc7e90\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/agonistica\/wp-json\/wp\/v2\/pages\/6293\" \/>\n\t<div class=\"um-col-alt\">\n\n\t\t\n\t\t\t<div class=\"um-left um-half\">\n\t\t\t\t<input type=\"submit\" value=\"Registrati\" class=\"um-button\" id=\"um-submit-btn\" \/>\n\t\t\t<\/div>\n\t\t\t<div class=\"um-right um-half\">\n\t\t\t\t<a href=\"https:\/\/www.dinamicassd.it\/agonistica\/login\/\" class=\"um-button um-alt\">\n\t\t\t\t\tLogin\t\t\t\t<\/a>\n\t\t\t<\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\n\t<\/div>\n\n\t\t\t<\/form>\n\t<\/div>\n<\/div>\n\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-6293","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/pages\/6293","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/comments?post=6293"}],"version-history":[{"count":4,"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/pages\/6293\/revisions"}],"predecessor-version":[{"id":6311,"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/pages\/6293\/revisions\/6311"}],"wp:attachment":[{"href":"https:\/\/www.dinamicassd.it\/agonistica\/wp-json\/wp\/v2\/media?parent=6293"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}