HSA Herbstcamps 2018 Anmeldung – Woche 1

HSA Camps

<link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css"><style type="text/css"> #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; } /* Add your own MailChimp form style overrides in your site stylesheet or in this style block. We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */</style><div id="mc_embed_signup"><form action="https://heidlersocceracademy.us17.list-manage.com/subscribe/post?u=831b790b9604f860f027e7bc2&id=5420515736" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate> <div id="mc_embed_signup_scroll"> <span class="headline">Anmeldung HSA Herbstcamp 2018 – Woche 1</span><div class="indicates-required"><span class="asterisk">*</span> Pflichtfelder </div><div class="mc-field-group input-group"> <strong>Anmeldung <span class="asterisk">*</span></strong> <ul><li><input type="radio" value="Hiermit melde ich mein Kind verbindlich für das HSA Herbstcamp vom 08.10. - 12.10.2018 an." name="ANMELDUNG" id="mce-ANMELDUNG-0"><label for="mce-ANMELDUNG-0">Hiermit melde ich mein Kind verbindlich für das HSA Herbstcamp vom 08.10. - 12.10.2018 an.</label></li></ul></div><div class="mc-field-group"> <label for="mce-FNAMECHILD">Vorname des Kindes <span class="asterisk">*</span></label> <input type="text" value="" name="FNAMECHILD" class="required" id="mce-FNAMECHILD"></div><div class="mc-field-group"> <label for="mce-LNAMECHILD">Nachname des Kindes <span class="asterisk">*</span></label> <input type="text" value="" name="LNAMECHILD" class="required" id="mce-LNAMECHILD"></div><div class="mc-field-group size1of2"> <label for="mce-BIRTHCHILD-month">Geburtsdatum des Kindes <span class="asterisk">*</span></label> <div class="datefield"> <span class="subfield dayfield"><input class="datepart required" type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="BIRTHCHILD[day]" id="mce-BIRTHCHILD-day"></span> /  <span class="subfield monthfield"><input class="datepart required" type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="BIRTHCHILD[month]" id="mce-BIRTHCHILD-month"></span> /  <span class="subfield yearfield"><input class="datepart required" type="text" pattern="[0-9]*" value="" placeholder="YYYY" size="4" maxlength="4" name="BIRTHCHILD[year]" id="mce-BIRTHCHILD-year"></span> <span class="small-meta nowrap">( dd / mm / yyyy )</span> </div></div><div class="mc-field-group"> <label for="mce-STRASSE">Strasse <span class="asterisk">*</span></label> <input type="text" value="" name="STRASSE" class="required" id="mce-STRASSE"></div><div class="mc-field-group"> <label for="mce-PLZ">PLZ <span class="asterisk">*</span></label> <input type="text" value="" name="PLZ" class="required" id="mce-PLZ"></div><div class="mc-field-group"> <label for="mce-ORT">Ort <span class="asterisk">*</span></label> <input type="text" value="" name="ORT" class="required" id="mce-ORT"></div><div class="mc-field-group input-group"> <strong>Preis <span class="asterisk">*</span></strong> <ul><li><input type="radio" value="Normal (190 €)" name="PREIS" id="mce-PREIS-0"><label for="mce-PREIS-0">Normal (190 €)</label></li><li><input type="radio" value="Geschwisterkind/Wiederholer (170 €)" name="PREIS" id="mce-PREIS-1"><label for="mce-PREIS-1">Geschwisterkind/Wiederholer (170 €)</label></li><li><input type="radio" value="HSA Mitglied (152 €)" name="PREIS" id="mce-PREIS-2"><label for="mce-PREIS-2">HSA Mitglied (152 €)</label></li></ul></div><div class="mc-field-group input-group"> <strong>Trikotgröße <span class="asterisk">*</span></strong> <ul><li><input type="radio" value="116" name="TRIKOT" id="mce-TRIKOT-0"><label for="mce-TRIKOT-0">116</label></li><li><input type="radio" value="128" name="TRIKOT" id="mce-TRIKOT-1"><label for="mce-TRIKOT-1">128</label></li><li><input type="radio" value="140" name="TRIKOT" id="mce-TRIKOT-2"><label for="mce-TRIKOT-2">140</label></li><li><input type="radio" value="152" name="TRIKOT" id="mce-TRIKOT-3"><label for="mce-TRIKOT-3">152</label></li><li><input type="radio" value="164" name="TRIKOT" id="mce-TRIKOT-4"><label for="mce-TRIKOT-4">164</label></li></ul></div><div class="mc-field-group"> <label for="mce-FNPARENT">Vorname des Erziehungsberechtigten <span class="asterisk">*</span></label> <input type="text" value="" name="FNPARENT" class="required" id="mce-FNPARENT"></div><div class="mc-field-group"> <label for="mce-LNPARENT">Nachname des Erziehungsberechtigten <span class="asterisk">*</span></label> <input type="text" value="" name="LNPARENT" class="required" id="mce-LNPARENT"></div><div class="mc-field-group"> <label for="mce-TELEFON">Telefon <span class="asterisk">*</span></label> <input type="text" value="" name="TELEFON" class="required" id="mce-TELEFON"></div><div class="mc-field-group"> <label for="mce-EMAIL">E-Mail <span class="asterisk">*</span></label> <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL"></div><div class="mc-field-group input-group"> <strong>Einzugsermächtigung <span class="asterisk">*</span></strong> <ul><li><input type="radio" value="Hiermit ermächtige(n) ich/wir Sie widerruflich die von mir /uns zu entrichtenden Zahlungen an die Heidler Soccer Academy bei Fälligkeit zu Lasten meines Kontos durch Lastschrift einzuziehen." name="EINZUG" id="mce-EINZUG-0"><label for="mce-EINZUG-0">Hiermit ermächtige(n) ich/wir Sie widerruflich die von mir /uns zu entrichtenden Zahlungen an die Heidler Soccer Academy bei Fälligkeit zu Lasten meines Kontos durch Lastschrift einzuziehen.</label></li></ul></div><div class="mc-field-group"> <label for="mce-FNKONTO">Vorname des Kontoinhabers <span class="asterisk">*</span></label> <input type="text" value="" name="FNKONTO" class="required" id="mce-FNKONTO"></div><div class="mc-field-group"> <label for="mce-LNKONTO">Nachname des Kontoinhabers <span class="asterisk">*</span></label> <input type="text" value="" name="LNKONTO" class="required" id="mce-LNKONTO"></div><div class="mc-field-group"> <label for="mce-IBAN">IBAN <span class="asterisk">*</span></label> <input type="text" value="" name="IBAN" class="required" id="mce-IBAN"></div><div class="mc-field-group"> <label for="mce-BICBLZ">BIC/Bankleitzahl <span class="asterisk">*</span></label> <input type="text" value="" name="BICBLZ" class="required" id="mce-BICBLZ"></div><div class="mc-field-group"> <label for="mce-NAMEKREDIT">Name des Kreditinstitutes <span class="asterisk">*</span></label> <input type="text" value="" name="NAMEKREDIT" class="required" id="mce-NAMEKREDIT"></div><div class="mc-field-group input-group"> <strong>AGB <span class="asterisk">*</span></strong> <ul><li><input type="radio" value="Ja, ich habe die Allgemeinen Geschäftsbedingungen (AGB) der Heidler Soccer Academy gelesen und akzeptiere diese." name="AGB" id="mce-AGB-0"><label for="mce-AGB-0">Ja, ich habe die Allgemeinen Geschäftsbedingungen (AGB) der Heidler Soccer Academy gelesen und akzeptiere diese.</label></li></ul></div><div class="mc-field-group"> <label for="mce-ANMERK">Anmerkungen </label> <input type="text" value="" name="ANMERK" class="" id="mce-ANMERK"></div> <div id="mce-responses" class="clear"> <div class="response" id="mce-error-response" style="display:none"></div> <div class="response" id="mce-success-response" style="display:none"></div> </div>  <div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_831b790b9604f860f027e7bc2_5420515736" tabindex="-1" value=""></div> <div class="clear"><input type="submit" value="Anmelden" name="subscribe" id="mc-embedded-subscribe" class="button"></div> </div></form></div><script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[3]='ANMELDUNG';ftypes[3]='radio';fnames[1]='FNAMECHILD';ftypes[1]='text';fnames[2]='LNAMECHILD';ftypes[2]='text';fnames[4]='BIRTHCHILD';ftypes[4]='date';fnames[5]='STRASSE';ftypes[5]='text';fnames[6]='PLZ';ftypes[6]='zip';fnames[7]='ORT';ftypes[7]='text';fnames[8]='PREIS';ftypes[8]='radio';fnames[9]='TRIKOT';ftypes[9]='radio';fnames[10]='FNPARENT';ftypes[10]='text';fnames[11]='LNPARENT';ftypes[11]='text';fnames[12]='TELEFON';ftypes[12]='text';fnames[0]='EMAIL';ftypes[0]='email';fnames[13]='EINZUG';ftypes[13]='radio';fnames[14]='FNKONTO';ftypes[14]='text';fnames[15]='LNKONTO';ftypes[15]='text';fnames[16]='IBAN';ftypes[16]='text';fnames[17]='BICBLZ';ftypes[17]='text';fnames[18]='NAMEKREDIT';ftypes[18]='text';fnames[19]='AGB';ftypes[19]='radio';fnames[20]='ANMERK';ftypes[20]='text'; /* * Translated default messages for the $ validation plugin. * Locale: DE */$.extend($.validator.messages, { required: "Dieses Feld ist ein Pflichtfeld.", maxlength: $.validator.format("Geben Sie bitte maximal {0} Zeichen ein."), minlength: $.validator.format("Geben Sie bitte mindestens {0} Zeichen ein."), rangelength: $.validator.format("Geben Sie bitte mindestens {0} und maximal {1} Zeichen ein."), email: "Geben Sie bitte eine gültige E-Mail Adresse ein.", url: "Geben Sie bitte eine gültige URL ein.", date: "Bitte geben Sie ein gültiges Datum ein.", number: "Geben Sie bitte eine Nummer ein.", digits: "Geben Sie bitte nur Ziffern ein.", equalTo: "Bitte denselben Wert wiederholen.", range: $.validator.format("Geben Sie bitten einen Wert zwischen {0} und {1}."), max: $.validator.format("Geben Sie bitte einen Wert kleiner oder gleich {0} ein."), min: $.validator.format("Geben Sie bitte einen Wert größer oder gleich {0} ein."), creditcard: "Geben Sie bitte ein gültige Kreditkarten-Nummer ein."});}(jQuery));var $mcj = jQuery.noConflict(true);</script>