{"id":2742,"date":"2025-10-04T15:01:27","date_gmt":"2025-10-04T13:01:27","guid":{"rendered":"https:\/\/equipepaarden.nl\/?page_id=2742"},"modified":"2026-01-16T19:45:13","modified_gmt":"2026-01-16T18:45:13","slug":"application-form","status":"publish","type":"page","link":"https:\/\/equipepaarden.nl\/en\/aanvraagformulier\/","title":{"rendered":"Application form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"2742\" class=\"elementor elementor-2742\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-35a62b2 e-flex e-con-boxed e-con e-parent\" data-id=\"35a62b2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;shape_divider_bottom&quot;:&quot;curve&quot;,&quot;shape_divider_bottom_negative&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-shape elementor-shape-bottom\" aria-hidden=\"true\" data-negative=\"true\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 1000 100\" preserveaspectratio=\"none\">\n\t<path class=\"elementor-shape-fill\" d=\"M500,97C126.7,96.3,0.8,19.8,0,0v100l1000,0V1C1000,19.4,873.3,97.8,500,97z\"\/>\n<\/svg>\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-48e395f e-con-full e-flex e-con e-child\" data-id=\"48e395f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d969e54 elementor-widget elementor-widget-heading\" data-id=\"d969e54\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Application form<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-474b6af e-flex e-con-boxed e-con e-parent\" data-id=\"474b6af\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-0a394fc e-con-full e-flex e-con e-child\" data-id=\"0a394fc\" data-element_type=\"container\" data-e-type=\"container\" id=\"form-container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-24b050d elementor-widget elementor-widget-shortcode\" data-id=\"24b050d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-2717 forminator-design--default forminator-enclosed forminator_ajax draft-enabled\" data-forminator-render=\"0\" data-form=\"forminator-module-2717\" data-uid=\"6af5686f0304b\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-2717\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-2717 forminator-design--default forminator-enclosed forminator_ajax draft-enabled\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"2717\"\n\t\t\t\tenctype=\"multipart\/form-data\" data-color-option=\"theme\" data-design=\"default\" data-grid=\"enclosed\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6af5686f0304b\" action=\"\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div role=\"tablist\" class=\"forminator-pagination-steps\" aria-label=\"Pagination\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"Finish\"\n\t\t\t\tdata-actual-label=\"Gegevens verzekeringnemer\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6af5686f0304b\" id=\"forminator-field-date-1-picker_6af5686f0304b-label\" class=\"forminator-label\">Desired start date <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-1-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-46\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-46_6af5686f0304b\" id=\"forminator-field-text-46_6af5686f0304b-label\" class=\"forminator-label\">First name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-46\" value=\"\" placeholder=\"\" id=\"forminator-field-text-46_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6af5686f0304b\" id=\"forminator-field-text-2_6af5686f0304b-label\" class=\"forminator-label\">Surname <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6af5686f0304b\" id=\"forminator-field-text-1_6af5686f0304b-label\" class=\"forminator-label\">Initials <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6af5686f0304b\" id=\"forminator-field-text-3_6af5686f0304b-label\" class=\"forminator-label\">Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6af5686f0304b\" id=\"forminator-field-text-4_6af5686f0304b-label\" class=\"forminator-label\">Postal code <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6af5686f0304b\" id=\"forminator-field-text-5_6af5686f0304b-label\" class=\"forminator-label\">Place of residence <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-date-2-picker_6af5686f0304b\" id=\"forminator-field-date-2-picker_6af5686f0304b-label\" class=\"forminator-label\">Date of birth <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-2\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-2-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-form-2717__field--select-1_6af5686f0304b\" id=\"forminator-form-2717__field--select-1_6af5686f0304b-label\" class=\"forminator-label\">Gender <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-2717__field--select-1_6af5686f0304b\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-1\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Selecteer geslacht\" data-search=\"true\" data-search-placeholder=\"Selecteer geslacht\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-2717__field--select-1_6af5686f0304b-label\"><option value=\"\"  >Select gender<\/option><option value=\"Man\"  data-calculation=\"0\">Man<\/option><option value=\"Vrouw\"  data-calculation=\"0\">Woman<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6af5686f0304b\" id=\"forminator-field-phone-1_6af5686f0304b-label\" class=\"forminator-label\">Private phone <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6af5686f0304b\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><div id=\"phone-2\" class=\"forminator-field-phone forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2_6af5686f0304b\" id=\"forminator-field-phone-2_6af5686f0304b-label\" class=\"forminator-label\">Mobile phone<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-2_6af5686f0304b\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6af5686f0304b\" id=\"forminator-field-email-1_6af5686f0304b-label\" class=\"forminator-label\">E-mail <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6af5686f0304b\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6af5686f0304b\" id=\"forminator-field-text-6_6af5686f0304b-label\" class=\"forminator-label\">IBAN account <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"Gegevens verzekeringnemer\"\n\t\t\t\tdata-actual-label=\"Gegevens verzekerd paard\"\n\t\t\t\tdata-name=\"page-break-2\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6af5686f0304b\" id=\"forminator-field-text-7_6af5686f0304b-label\" class=\"forminator-label\">Horse name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"date-3\" class=\"forminator-field-date forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-date-3-picker_6af5686f0304b\" id=\"forminator-field-date-3-picker_6af5686f0304b-label\" class=\"forminator-label\">Date of birth <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-3\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-3-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"2010\" data-end-year=\"2026\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"2010-11-12\" data-end-date=\"2026-11-13\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6af5686f0304b\" id=\"forminator-field-text-8_6af5686f0304b-label\" class=\"forminator-label\">Chip number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_6af5686f0304b\" id=\"forminator-field-text-9_6af5686f0304b-label\" class=\"forminator-label\">Life number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_6af5686f0304b\" id=\"forminator-field-text-10_6af5686f0304b-label\" class=\"forminator-label\">Colour <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"select-2\" class=\"forminator-field-select forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-form-2717__field--select-2_6af5686f0304b\" id=\"forminator-form-2717__field--select-2_6af5686f0304b-label\" class=\"forminator-label\">Gender <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-2717__field--select-2_6af5686f0304b\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-2\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Selecteer geslacht\" data-search=\"true\" data-search-placeholder=\"Selecteer geslacht\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-2717__field--select-2_6af5686f0304b-label\"><option value=\"\"  >Select gender<\/option><option value=\"Hengst\"  data-calculation=\"0\">Stallion<\/option><option value=\"Merrie\"  data-calculation=\"0\">Mare<\/option><option value=\"Ruin\"  data-calculation=\"0\">Ruin<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_6af5686f0304b\" id=\"forminator-field-text-11_6af5686f0304b-label\" class=\"forminator-label\">Breed\/pedigree <span class=\"forminator-required\">*<\/span><\/label><span id=\"forminator-field-text-11_6af5686f0304b-description\" class=\"forminator-description\">E.g. KWPN, BWP or Hanoverian. Unknown? Then enter &#039;unknown&#039;.<\/span><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" aria-describedby=\"forminator-field-text-11_6af5686f0304b-description\" \/><\/div><\/div><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_6af5686f0304b\" id=\"forminator-field-text-12_6af5686f0304b-label\" class=\"forminator-label\">Descent<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-13_6af5686f0304b\" id=\"forminator-field-text-13_6af5686f0304b-label\" class=\"forminator-label\">Height at withers<\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-14\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-14_6af5686f0304b\" id=\"forminator-field-text-14_6af5686f0304b-label\" class=\"forminator-label\">Stable address <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6af5686f0304b\" id=\"forminator-field-textarea-1_6af5686f0304b-label\" class=\"forminator-label\">Markings <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_6af5686f0304b\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:60px;\" ><\/textarea><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-2\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-2-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"2\"\n\t\t\t\tdata-label=\"Gegevens verzekerd paard\"\n\t\t\t\tdata-actual-label=\"Verzekeringsvoorwaarden\"\n\t\t\t\tdata-name=\"page-break-3\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6af5686f0304b\" id=\"forminator-field-number-1_6af5686f0304b-label\" class=\"forminator-label\">Insured value (\u20ac) <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_6af5686f0304b\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product insurance-equipe2\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-1-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-1-6af5686f0304b-label\" class=\"forminator-label\">Choose an insurance<\/span><label id=\"forminator-field-checkbox-1-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-1-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Team 2 Horse Insurance\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Equipe 2 Paardenverzekering\" id=\"forminator-field-checkbox-1-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-1-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Team 2 Horse Insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-2\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-2-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-2-6af5686f0304b-label\" class=\"forminator-label\">Supplementary Equipe 2 Health Insurance<\/span><label id=\"forminator-field-checkbox-2-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-2-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Supplementary Equipe 2 Health Insurance\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"Aanvullende Equipe 2 Ziektekostenverzekering\" id=\"forminator-field-checkbox-2-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-2-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Supplementary Equipe 2 Health Insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-3\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product label-hide insurance-equipe3\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-3-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-3-6af5686f0304b-label\" class=\"forminator-label\">Choose an insurance<\/span><label id=\"forminator-field-checkbox-3-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-3-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Equipe 3 Horse Insurance\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Equipe 3 Paardenverzekering\" id=\"forminator-field-checkbox-3-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-3-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Equipe 3 Horse Insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-4\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-4-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-4-6af5686f0304b-label\" class=\"forminator-label\">Supplementary Equipe 3 Health Insurance<\/span><label id=\"forminator-field-checkbox-4-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-4-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Supplementary Equipe 3 Health Insurance\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"Aanvullende Equipe 3 Ziektekostenverzekering\" id=\"forminator-field-checkbox-4-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-4-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Supplementary Equipe 3 Health Insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-5\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product label-hide insurance-equipe4\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-5-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-5-6af5686f0304b-label\" class=\"forminator-label\">Choose an insurance<\/span><label id=\"forminator-field-checkbox-5-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-5-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Equipe 4 Horse Insurance\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"Equipe 4 Paardenverzekering\" id=\"forminator-field-checkbox-5-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-5-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Equipe 4 Horse Insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-6\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-6-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-6-6af5686f0304b-label\" class=\"forminator-label\">Equipe 4 - Additional Equipe 4 and 4+<\/span><label id=\"forminator-field-checkbox-6-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-6-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Supplementary Equipe 4 Health Insurance\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"Aanvullende Equipe 4 Ziektekostenverzekering\" id=\"forminator-field-checkbox-6-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-6-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Supplementary Equipe 4 Health Insurance<\/span><\/label><label id=\"forminator-field-checkbox-6-2-6af5686f0304b-label\" for=\"forminator-field-checkbox-6-2-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Supplementary Equipe 4+ Health Insurance (only available for insured values of \u20ac5,000 or more)\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"Aanvullende-Equipe-4+-Ziektekostenverzekering-(alleen-mogelijk-vanaf-een-verzekerde-waarde-van-\u20ac-5000,-)\" id=\"forminator-field-checkbox-6-2-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-6-2-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Supplementary Equipe 4+ Health Insurance (only available for insured values of \u20ac5,000 or more)<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-7\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-7-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-7-6af5686f0304b-label\" class=\"forminator-label\">Team Health Insurance Horse<\/span><label id=\"forminator-field-checkbox-7-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-7-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Team Health Insurance Horse\"><input type=\"checkbox\" name=\"checkbox-7[]\" value=\"Equipe Zorgverzekering Paard\" id=\"forminator-field-checkbox-7-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-7-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Team Health Insurance Horse<\/span><\/label><\/div><\/div><div id=\"checkbox-8\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-8-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-8-6af5686f0304b-label\" class=\"forminator-label\">Stallion insurance<\/span><label id=\"forminator-field-checkbox-8-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-8-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Stallion insurance\"><input type=\"checkbox\" name=\"checkbox-8[]\" value=\"Dekhengstenverzekering\" id=\"forminator-field-checkbox-8-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-8-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Stallion insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-9\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-9-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-9-6af5686f0304b-label\" class=\"forminator-label\">Cremation insurance<\/span><label id=\"forminator-field-checkbox-9-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-9-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Cremation insurance\"><input type=\"checkbox\" name=\"checkbox-9[]\" value=\"Crematieverzekering\" id=\"forminator-field-checkbox-9-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-9-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Cremation insurance<\/span><\/label><\/div><\/div><div id=\"checkbox-10\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-10-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-10-6af5686f0304b-label\" class=\"forminator-label\">Collective horse insurance<\/span><label id=\"forminator-field-checkbox-10-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-10-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Collective horse insurance\"><input type=\"checkbox\" name=\"checkbox-10[]\" value=\"Collectieve paardenverzekering\" id=\"forminator-field-checkbox-10-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-10-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Collective horse insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-11\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-11-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-11-6af5686f0304b-label\" class=\"forminator-label\">Fetus-foal insurance<\/span><label id=\"forminator-field-checkbox-11-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-11-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Fetus-foal insurance\"><input type=\"checkbox\" name=\"checkbox-11[]\" value=\"Foetus-veulenverzekering\" id=\"forminator-field-checkbox-11-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-11-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Fetus-foal insurance<\/span><\/label><\/div><\/div><div id=\"checkbox-12\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-12-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-12-6af5686f0304b-label\" class=\"forminator-label\">Birth foal insurance<\/span><label id=\"forminator-field-checkbox-12-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-12-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Birth foal insurance\"><input type=\"checkbox\" name=\"checkbox-12[]\" value=\"Geboorte-veulenverzekering\" id=\"forminator-field-checkbox-12-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-12-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Birth foal insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12\"><span id=\"forminator-field-group-1_6af5686f0304b-label\" class=\"forminator-label forminator-repeater-label\">Only applicable for Foetus-Foal Insurance and Birth-Foal Insurance<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\" role=\"group\" aria-labelledby=\"forminator-field-group-1_6af5686f0304b-label\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"date-4\" class=\"forminator-field-date forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-date-4-picker_6af5686f0304b\" id=\"forminator-field-date-4-picker_6af5686f0304b-label\" class=\"forminator-label\">What is the last mating date?<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-4\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-4-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><div id=\"text-15\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-15_6af5686f0304b\" id=\"forminator-field-text-15_6af5686f0304b-label\" class=\"forminator-label\">Stallion name<\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-2\" class=\"forminator-field-number forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-number-2_6af5686f0304b\" id=\"forminator-field-number-2_6af5686f0304b-label\" class=\"forminator-label\">What is the stud fee?<\/label><input name=\"number-2\" value=\"\" placeholder=\"\" id=\"forminator-field-number-2_6af5686f0304b\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" \/><\/div><\/div><div id=\"text-16\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-16_6af5686f0304b\" id=\"forminator-field-text-16_6af5686f0304b-label\" class=\"forminator-label\">Studbook<\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\" id=\"forminator-field-text-16_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-1-6af5686f0304b-label\" class=\"forminator-label\">Has the mare ever been pregnant?<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-1\" value=\"Ja\" id=\"forminator-field-radio-1-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-1\" value=\"Nee\" id=\"forminator-field-radio-1-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-2-6af5686f0304b-label\" class=\"forminator-label\">If so, has the mare ever had a premature birth, a dead foal, or a failed pregnancy?<\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-2\" value=\"Ja\" id=\"forminator-field-radio-2-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-2\" value=\"Nee\" id=\"forminator-field-radio-2-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-44\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-44_6af5686f0304b\" id=\"forminator-field-text-44_6af5686f0304b-label\" class=\"forminator-label\">Please explain.<\/label><input type=\"text\" name=\"text-44\" value=\"\" placeholder=\"\" id=\"forminator-field-text-44_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-21\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-21-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-21-6af5686f0304b-label\" class=\"forminator-label\">Have any abnormal circumstances, such as abnormal delivery, ejection of the uterus, etc., occurred in the mare previously during or after birth?<\/span><label id=\"forminator-field-radio-21-label-1\" for=\"forminator-field-radio-21-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-21\" value=\"Ja\" id=\"forminator-field-radio-21-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-21-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-21-label-2\" for=\"forminator-field-radio-21-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-21\" value=\"Nee\" id=\"forminator-field-radio-21-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-21-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><label id=\"forminator-field-radio-21-label-3\" for=\"forminator-field-radio-21-3-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Third Choice\"><input type=\"radio\" name=\"radio-21\" value=\"Third-Choice\" id=\"forminator-field-radio-21-3-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-21-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Third Choice<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-17\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-17_6af5686f0304b\" id=\"forminator-field-text-17_6af5686f0304b-label\" class=\"forminator-label\">Please explain.<\/label><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-18\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-18_6af5686f0304b\" id=\"forminator-field-text-18_6af5686f0304b-label\" class=\"forminator-label\">How many pregnant mares do you own?<\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-4\" class=\"forminator-field-html forminator-col forminator-col-12  label-ttl\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-4\"><p><strong>Please include the documents below. You can also send them by email, fax, or mail, if you prefer.<\/strong><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6af5686f0304b\" id=\"forminator-field-upload-1_6af5686f0304b-label\" class=\"forminator-label\">A copy of the stud certificate<\/label><div class=\"forminator-file-upload\" data-element=\"upload-1_6af5686f0304b\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_6af5686f0304b\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.heif,.heics,.heifs,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.x-wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svgz,.cdr,.ai,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/x-icon,image\/heic,image\/heif,image\/heic-sequence,image\/heif-sequence,video\/x-ms-asf,video\/x-ms-wmv,video\/x-ms-wmx,video\/x-ms-wm,video\/avi,video\/divx,video\/x-flv,video\/quicktime,video\/mpeg,video\/mp4,video\/ogg,video\/webm,video\/x-matroska,video\/3gpp,video\/3gpp2,text\/plain,text\/csv,text\/tab-separated-values,text\/calendar,text\/vtt,audio\/mpeg,audio\/aac,audio\/x-realaudio,audio\/wav,audio\/ogg,audio\/flac,audio\/midi,audio\/x-ms-wma,audio\/x-ms-wax,audio\/x-matroska,application\/rtf,application\/pdf,application\/java,application\/x-tar,application\/zip,application\/x-gzip,application\/x-7z-compressed,application\/octet-stream,application\/msword,application\/vnd.ms-powerpoint,application\/vnd.ms-write,application\/vnd.ms-excel,application\/vnd.ms-access,application\/vnd.ms-project,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.ms-word.document.macroEnabled.12,application\/vnd.openxmlformats-officedocument.wordprocessingml.template,application\/vnd.ms-word.template.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application\/vnd.ms-excel.sheet.macroEnabled.12,application\/vnd.ms-excel.sheet.binary.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.template,application\/vnd.ms-excel.template.macroEnabled.12,application\/vnd.ms-excel.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.presentation,application\/vnd.ms-powerpoint.presentation.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slideshow,application\/vnd.ms-powerpoint.slideshow.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.template,application\/vnd.ms-powerpoint.template.macroEnabled.12,application\/vnd.ms-powerpoint.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slide,application\/vnd.ms-powerpoint.slide.macroEnabled.12,application\/onenote,application\/oxps,application\/vnd.ms-xpsdocument,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.presentation,application\/vnd.oasis.opendocument.spreadsheet,application\/vnd.oasis.opendocument.graphics,application\/vnd.oasis.opendocument.chart,application\/vnd.oasis.opendocument.database,application\/vnd.oasis.opendocument.formula,application\/wordperfect,application\/vnd.apple.keynote,application\/vnd.apple.numbers,application\/vnd.apple.pages\" tabindex=\"-1\"><button id=\"forminator-field-upload-1_6af5686f0304b_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_6af5686f0304b\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><div id=\"upload-2\" class=\"forminator-field-upload forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-upload-2_6af5686f0304b\" id=\"forminator-field-upload-2_6af5686f0304b-label\" class=\"forminator-label\">Invoice for the stud fee<\/label><div class=\"forminator-file-upload\" data-element=\"upload-2_6af5686f0304b\"><input type=\"file\" name=\"upload-2\" id=\"forminator-field-upload-2_6af5686f0304b\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.heif,.heics,.heifs,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.x-wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svgz,.cdr,.ai,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/x-icon,image\/heic,image\/heif,image\/heic-sequence,image\/heif-sequence,video\/x-ms-asf,video\/x-ms-wmv,video\/x-ms-wmx,video\/x-ms-wm,video\/avi,video\/divx,video\/x-flv,video\/quicktime,video\/mpeg,video\/mp4,video\/ogg,video\/webm,video\/x-matroska,video\/3gpp,video\/3gpp2,text\/plain,text\/csv,text\/tab-separated-values,text\/calendar,text\/vtt,audio\/mpeg,audio\/aac,audio\/x-realaudio,audio\/wav,audio\/ogg,audio\/flac,audio\/midi,audio\/x-ms-wma,audio\/x-ms-wax,audio\/x-matroska,application\/rtf,application\/pdf,application\/java,application\/x-tar,application\/zip,application\/x-gzip,application\/x-7z-compressed,application\/octet-stream,application\/msword,application\/vnd.ms-powerpoint,application\/vnd.ms-write,application\/vnd.ms-excel,application\/vnd.ms-access,application\/vnd.ms-project,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.ms-word.document.macroEnabled.12,application\/vnd.openxmlformats-officedocument.wordprocessingml.template,application\/vnd.ms-word.template.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application\/vnd.ms-excel.sheet.macroEnabled.12,application\/vnd.ms-excel.sheet.binary.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.template,application\/vnd.ms-excel.template.macroEnabled.12,application\/vnd.ms-excel.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.presentation,application\/vnd.ms-powerpoint.presentation.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slideshow,application\/vnd.ms-powerpoint.slideshow.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.template,application\/vnd.ms-powerpoint.template.macroEnabled.12,application\/vnd.ms-powerpoint.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slide,application\/vnd.ms-powerpoint.slide.macroEnabled.12,application\/onenote,application\/oxps,application\/vnd.ms-xpsdocument,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.presentation,application\/vnd.oasis.opendocument.spreadsheet,application\/vnd.oasis.opendocument.graphics,application\/vnd.oasis.opendocument.chart,application\/vnd.oasis.opendocument.database,application\/vnd.oasis.opendocument.formula,application\/wordperfect,application\/vnd.apple.keynote,application\/vnd.apple.numbers,application\/vnd.apple.pages\" tabindex=\"-1\"><button id=\"forminator-field-upload-2_6af5686f0304b_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-2_6af5686f0304b\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-3\" class=\"forminator-field-upload forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-upload-3_6af5686f0304b\" id=\"forminator-field-upload-3_6af5686f0304b-label\" class=\"forminator-label\">Recent health and pregnancy certificate from the veterinarian (after at least 90 days of pregnancy)<\/label><div class=\"forminator-file-upload\" data-element=\"upload-3_6af5686f0304b\"><input type=\"file\" name=\"upload-3\" id=\"forminator-field-upload-3_6af5686f0304b\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.heif,.heics,.heifs,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.x-wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svgz,.cdr,.ai,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/x-icon,image\/heic,image\/heif,image\/heic-sequence,image\/heif-sequence,video\/x-ms-asf,video\/x-ms-wmv,video\/x-ms-wmx,video\/x-ms-wm,video\/avi,video\/divx,video\/x-flv,video\/quicktime,video\/mpeg,video\/mp4,video\/ogg,video\/webm,video\/x-matroska,video\/3gpp,video\/3gpp2,text\/plain,text\/csv,text\/tab-separated-values,text\/calendar,text\/vtt,audio\/mpeg,audio\/aac,audio\/x-realaudio,audio\/wav,audio\/ogg,audio\/flac,audio\/midi,audio\/x-ms-wma,audio\/x-ms-wax,audio\/x-matroska,application\/rtf,application\/pdf,application\/java,application\/x-tar,application\/zip,application\/x-gzip,application\/x-7z-compressed,application\/octet-stream,application\/msword,application\/vnd.ms-powerpoint,application\/vnd.ms-write,application\/vnd.ms-excel,application\/vnd.ms-access,application\/vnd.ms-project,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.ms-word.document.macroEnabled.12,application\/vnd.openxmlformats-officedocument.wordprocessingml.template,application\/vnd.ms-word.template.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application\/vnd.ms-excel.sheet.macroEnabled.12,application\/vnd.ms-excel.sheet.binary.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.template,application\/vnd.ms-excel.template.macroEnabled.12,application\/vnd.ms-excel.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.presentation,application\/vnd.ms-powerpoint.presentation.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slideshow,application\/vnd.ms-powerpoint.slideshow.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.template,application\/vnd.ms-powerpoint.template.macroEnabled.12,application\/vnd.ms-powerpoint.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slide,application\/vnd.ms-powerpoint.slide.macroEnabled.12,application\/onenote,application\/oxps,application\/vnd.ms-xpsdocument,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.presentation,application\/vnd.oasis.opendocument.spreadsheet,application\/vnd.oasis.opendocument.graphics,application\/vnd.oasis.opendocument.chart,application\/vnd.oasis.opendocument.database,application\/vnd.oasis.opendocument.formula,application\/wordperfect,application\/vnd.apple.keynote,application\/vnd.apple.numbers,application\/vnd.apple.pages\" tabindex=\"-1\"><button id=\"forminator-field-upload-3_6af5686f0304b_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-3_6af5686f0304b\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-13\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product, label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-13-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-13-6af5686f0304b-label\" class=\"forminator-label\">Castration insurance<\/span><label id=\"forminator-field-checkbox-13-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-13-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Castration insurance\"><input type=\"checkbox\" name=\"checkbox-13[]\" value=\"Castratieverzekering\" id=\"forminator-field-checkbox-13-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-13-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Castration insurance<\/span><\/label><\/div><\/div><div id=\"checkbox-14\" class=\"forminator-field-checkbox forminator-col forminator-col-6  insurance-product, label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-14-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-14-6af5686f0304b-label\" class=\"forminator-label\">Anesthesia risk insurance<\/span><label id=\"forminator-field-checkbox-14-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-14-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Anesthesia risk insurance\"><input type=\"checkbox\" name=\"checkbox-14[]\" value=\"Narcoserisicoverzekering\" id=\"forminator-field-checkbox-14-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-14-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Anesthesia risk insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-2\" class=\"forminator-field-group forminator-col forminator-col-12\"><span id=\"forminator-field-group-2_6af5686f0304b-label\" class=\"forminator-label forminator-repeater-label\">Only applicable for Castration and Anesthesia Risk Insurance**<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\" role=\"group\" aria-labelledby=\"forminator-field-group-2_6af5686f0304b-label\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"date-5\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-5-picker_6af5686f0304b\" id=\"forminator-field-date-5-picker_6af5686f0304b-label\" class=\"forminator-label\">Date of castration\/anesthesia<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-5\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-5-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-3-6af5686f0304b-label\" class=\"forminator-label\">Under full anesthesia?<\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-3\" value=\"Ja\" id=\"forminator-field-radio-3-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-3\" value=\"Nee\" id=\"forminator-field-radio-3-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-4\" class=\"forminator-field-upload forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-upload-4_6af5686f0304b\" id=\"forminator-field-upload-4_6af5686f0304b-label\" class=\"forminator-label\">Please include a health certificate from your veterinarian.<\/label><div class=\"forminator-file-upload\" data-element=\"upload-4_6af5686f0304b\"><input type=\"file\" name=\"upload-4\" id=\"forminator-field-upload-4_6af5686f0304b\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.heif,.heics,.heifs,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.x-wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svgz,.cdr,.ai,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/x-icon,image\/heic,image\/heif,image\/heic-sequence,image\/heif-sequence,video\/x-ms-asf,video\/x-ms-wmv,video\/x-ms-wmx,video\/x-ms-wm,video\/avi,video\/divx,video\/x-flv,video\/quicktime,video\/mpeg,video\/mp4,video\/ogg,video\/webm,video\/x-matroska,video\/3gpp,video\/3gpp2,text\/plain,text\/csv,text\/tab-separated-values,text\/calendar,text\/vtt,audio\/mpeg,audio\/aac,audio\/x-realaudio,audio\/wav,audio\/ogg,audio\/flac,audio\/midi,audio\/x-ms-wma,audio\/x-ms-wax,audio\/x-matroska,application\/rtf,application\/pdf,application\/java,application\/x-tar,application\/zip,application\/x-gzip,application\/x-7z-compressed,application\/octet-stream,application\/msword,application\/vnd.ms-powerpoint,application\/vnd.ms-write,application\/vnd.ms-excel,application\/vnd.ms-access,application\/vnd.ms-project,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.ms-word.document.macroEnabled.12,application\/vnd.openxmlformats-officedocument.wordprocessingml.template,application\/vnd.ms-word.template.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application\/vnd.ms-excel.sheet.macroEnabled.12,application\/vnd.ms-excel.sheet.binary.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.template,application\/vnd.ms-excel.template.macroEnabled.12,application\/vnd.ms-excel.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.presentation,application\/vnd.ms-powerpoint.presentation.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slideshow,application\/vnd.ms-powerpoint.slideshow.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.template,application\/vnd.ms-powerpoint.template.macroEnabled.12,application\/vnd.ms-powerpoint.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slide,application\/vnd.ms-powerpoint.slide.macroEnabled.12,application\/onenote,application\/oxps,application\/vnd.ms-xpsdocument,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.presentation,application\/vnd.oasis.opendocument.spreadsheet,application\/vnd.oasis.opendocument.graphics,application\/vnd.oasis.opendocument.chart,application\/vnd.oasis.opendocument.database,application\/vnd.oasis.opendocument.formula,application\/wordperfect,application\/vnd.apple.keynote,application\/vnd.apple.numbers,application\/vnd.apple.pages\" tabindex=\"-1\"><button id=\"forminator-field-upload-4_6af5686f0304b_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-4_6af5686f0304b\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-5\" class=\"forminator-field-html forminator-col forminator-col-12  notes-text\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-5\"><p>**Direct debit authorization.<\/p>\n<p>By signing this application form, the undersigned authorizes Equipe Horse Insurance to debit the premium due for this Castration or Surgical Insurance from his\/her bank\/giro account.<\/p><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-15\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product, label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-15-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-15-6af5686f0304b-label\" class=\"forminator-label\">Transport insurance<\/span><label id=\"forminator-field-checkbox-15-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-15-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Transport insurance\"><input type=\"checkbox\" name=\"checkbox-15[]\" value=\"Transportverzekering\" id=\"forminator-field-checkbox-15-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-15-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Transport insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-3\" class=\"forminator-field-group forminator-col forminator-col-12\"><span id=\"forminator-field-group-3_6af5686f0304b-label\" class=\"forminator-label forminator-repeater-label\">**Only applicable for Transport Insurance<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\" role=\"group\" aria-labelledby=\"forminator-field-group-3_6af5686f0304b-label\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"date-6\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-6-picker_6af5686f0304b\" id=\"forminator-field-date-6-picker_6af5686f0304b-label\" class=\"forminator-label\">Date of departure<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-6\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-6-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-19\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-19_6af5686f0304b\" id=\"forminator-field-text-19_6af5686f0304b-label\" class=\"forminator-label\">Departure address<\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-7\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-7-picker_6af5686f0304b\" id=\"forminator-field-date-7-picker_6af5686f0304b-label\" class=\"forminator-label\">Date of arrival at stable address<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-7\" value=\"\" placeholder=\"Day \/ Month \/ Year\" id=\"forminator-field-date-7-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"dd\/mm\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-21_6af5686f0304b\" id=\"forminator-field-text-21_6af5686f0304b-label\" class=\"forminator-label\">Stable address arrival<\/label><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-4\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-4-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-4-6af5686f0304b-label\" class=\"forminator-label\">Transport by<\/span><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Truck\"><input type=\"radio\" name=\"radio-4\" value=\"Vrachtwagen\" id=\"forminator-field-radio-4-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Truck<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Aeroplane\"><input type=\"radio\" name=\"radio-4\" value=\"Vliegtuig\" id=\"forminator-field-radio-4-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Aeroplane<\/span><\/label><label id=\"forminator-field-radio-4-label-3\" for=\"forminator-field-radio-4-3-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Ship\"><input type=\"radio\" name=\"radio-4\" value=\"Schip\" id=\"forminator-field-radio-4-3-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-4-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Ship<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-20\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-20_6af5686f0304b\" id=\"forminator-field-text-20_6af5686f0304b-label\" class=\"forminator-label\">Transport details<\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-22_6af5686f0304b\" id=\"forminator-field-text-22_6af5686f0304b-label\" class=\"forminator-label\">Any additional relevant information<\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-6\" class=\"forminator-field-html forminator-col forminator-col-12  notes-text\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-6\"><p>In the event of damage, a health certificate drawn up by a competent veterinarian must be submitted no later than one week before the start of the transport.<\/p>\n<p>**Direct debit authorization<\/p>\n<p>By signing this application form, the undersigned authorizes Equipe Horse Insurance to debit the premium due for this Transport Insurance from his\/her bank\/giro account.<\/p><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-16\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-16-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-16-6af5686f0304b-label\" class=\"forminator-label\">Trailer insurance<\/span><label id=\"forminator-field-checkbox-16-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-16-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Trailer insurance\"><input type=\"checkbox\" name=\"checkbox-16[]\" value=\"Trailerverzekering\" id=\"forminator-field-checkbox-16-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-16-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Trailer insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-7\" class=\"forminator-field-html forminator-col forminator-col-12  notes-text desc\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-7\"><p>* If you choose Saddle and\/or Trailer Insurance, you will receive a supplementary application form from us.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-17\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-17-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-17-6af5686f0304b-label\" class=\"forminator-label\">Saddle insurance<\/span><label id=\"forminator-field-checkbox-17-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-17-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Saddle insurance\"><input type=\"checkbox\" name=\"checkbox-17[]\" value=\"Zadelverzekering\" id=\"forminator-field-checkbox-17-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-17-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Saddle insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-8\" class=\"forminator-field-html forminator-col forminator-col-12  notes-text desc\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-8\"><p>* If you choose Saddle and\/or Trailer Insurance, you will receive a supplementary application form from us.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-18\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product, label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-18-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-18-6af5686f0304b-label\" class=\"forminator-label\">Accident-passenger insurance<\/span><label id=\"forminator-field-checkbox-18-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-18-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Accident-passenger insurance\"><input type=\"checkbox\" name=\"checkbox-18[]\" value=\"Ongevallen-opzittendenverzekering\" id=\"forminator-field-checkbox-18-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-18-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Accident-passenger insurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-9\" class=\"forminator-field-html forminator-col forminator-col-12  notes-text\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-9\"><p>Please refer to the insurance cards at www.equipepaarden.nl\/downloads. The insurance card provides you with the most relevant coverage information for each product at a glance.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-4\" class=\"forminator-field-group forminator-col forminator-col-12\"><span id=\"forminator-field-group-4_6af5686f0304b-label\" class=\"forminator-label forminator-repeater-label\">Purpose of use of the horse<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\" role=\"group\" aria-labelledby=\"forminator-field-group-4_6af5686f0304b-label\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"checkbox-19\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-19-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-19-6af5686f0304b-label\" class=\"forminator-label\">Dressage<\/span><label id=\"forminator-field-checkbox-19-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-19-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Dressage\"><input type=\"checkbox\" name=\"checkbox-19[]\" value=\"Dressuur\" id=\"forminator-field-checkbox-19-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-19-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Dressage<\/span><\/label><\/div><\/div><div id=\"checkbox-20\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-20-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-20-6af5686f0304b-label\" class=\"forminator-label\">Driving sport<\/span><label id=\"forminator-field-checkbox-20-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-20-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Driving sport\"><input type=\"checkbox\" name=\"checkbox-20[]\" value=\"Mensport\" id=\"forminator-field-checkbox-20-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-20-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Driving sport<\/span><\/label><\/div><\/div><div id=\"checkbox-21\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-21-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-21-6af5686f0304b-label\" class=\"forminator-label\">Harness racing<\/span><label id=\"forminator-field-checkbox-21-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-21-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Harness racing\"><input type=\"checkbox\" name=\"checkbox-21[]\" value=\"Ren-drafsport\" id=\"forminator-field-checkbox-21-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-21-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Harness racing<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-22\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-22-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-22-6af5686f0304b-label\" class=\"forminator-label\">Show jumping<\/span><label id=\"forminator-field-checkbox-22-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-22-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Show jumping\"><input type=\"checkbox\" name=\"checkbox-22[]\" value=\"Springsport\" id=\"forminator-field-checkbox-22-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-22-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Show jumping<\/span><\/label><\/div><\/div><div id=\"checkbox-23\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-23-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-23-6af5686f0304b-label\" class=\"forminator-label\">Eventing<\/span><label id=\"forminator-field-checkbox-23-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-23-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Eventing\"><input type=\"checkbox\" name=\"checkbox-23[]\" value=\"Eventing\" id=\"forminator-field-checkbox-23-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-23-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Eventing<\/span><\/label><\/div><\/div><div id=\"checkbox-24\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-24-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-24-6af5686f0304b-label\" class=\"forminator-label\">Breeding<\/span><label id=\"forminator-field-checkbox-24-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-24-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Breeding\"><input type=\"checkbox\" name=\"checkbox-24[]\" value=\"Fokkerij\" id=\"forminator-field-checkbox-24-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-24-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Breeding<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-25\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-25-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-25-6af5686f0304b-label\" class=\"forminator-label\">Recreation<\/span><label id=\"forminator-field-checkbox-25-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-25-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Recreation\"><input type=\"checkbox\" name=\"checkbox-25[]\" value=\"Recreatie\" id=\"forminator-field-checkbox-25-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-25-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Recreation<\/span><\/label><\/div><\/div><div id=\"checkbox-30\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-30-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-30-6af5686f0304b-label\" class=\"forminator-label\">Western sport<\/span><label id=\"forminator-field-checkbox-30-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-30-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Western sport\"><input type=\"checkbox\" name=\"checkbox-30[]\" value=\"Westernsport\" id=\"forminator-field-checkbox-30-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-30-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Western sport<\/span><\/label><\/div><\/div><div id=\"checkbox-26\" class=\"forminator-field-checkbox forminator-col forminator-col-4  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-26-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-26-6af5686f0304b-label\" class=\"forminator-label\">Endurance<\/span><label id=\"forminator-field-checkbox-26-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-26-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Endurance\"><input type=\"checkbox\" name=\"checkbox-26[]\" value=\"Endurance\" id=\"forminator-field-checkbox-26-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-26-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Endurance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-27\" class=\"forminator-field-checkbox forminator-col forminator-col-12  insurance-product label-hide\"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-27-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-27-6af5686f0304b-label\" class=\"forminator-label\">Otherwise nl.<\/span><label id=\"forminator-field-checkbox-27-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-27-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Otherwise nl.\"><input type=\"checkbox\" name=\"checkbox-27[]\" value=\"Anders nl.\" id=\"forminator-field-checkbox-27-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-27-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Otherwise nl.<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-23\" class=\"forminator-field-text forminator-col forminator-col-12  label-hide\"><div class=\"forminator-field\"><label for=\"forminator-field-text-23_6af5686f0304b\" id=\"forminator-field-text-23_6af5686f0304b-label\" class=\"forminator-label\">Anders nl<\/label><input type=\"text\" name=\"text-23\" value=\"\" placeholder=\"\" id=\"forminator-field-text-23_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-3\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-3-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"3\"\n\t\t\t\tdata-label=\"Verzekeringsvoorwaarden\"\n\t\t\t\tdata-actual-label=\"Dierenarts\"\n\t\t\t\tdata-name=\"page-break-4\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-45\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-45_6af5686f0304b\" id=\"forminator-field-text-45_6af5686f0304b-label\" class=\"forminator-label\">Name and full address of veterinarian:<\/label><input type=\"text\" name=\"text-45\" value=\"\" placeholder=\"\" id=\"forminator-field-text-45_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-24\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-24_6af5686f0304b\" id=\"forminator-field-text-24_6af5686f0304b-label\" class=\"forminator-label\">How many km do you live from the stable?<\/label><input type=\"text\" name=\"text-24\" value=\"\" placeholder=\"\" id=\"forminator-field-text-24_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-3\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-2717__field--select-3_6af5686f0304b\" id=\"forminator-form-2717__field--select-3_6af5686f0304b-label\" class=\"forminator-label\">Premium payment<\/label><select  id=\"forminator-form-2717__field--select-3_6af5686f0304b\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-3\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-2717__field--select-3_6af5686f0304b-label\"><option value=\"Per jaar\"  data-calculation=\"0\">Per year<\/option><option value=\"Per half jaar\"  data-calculation=\"0\">Every six months<\/option><option value=\"Per-kwartaal\"  data-calculation=\"0\">Per quarter<\/option><option value=\"Per-maand\"  data-calculation=\"0\">Per month<\/option><option value=\"Eenmalig-(in-geval-van-een-Transport-,-Castratie-,-Narcoserisico--of-andere-kortlopende-verzekering)\"  data-calculation=\"0\">One-off (in case of a Transport, Castration, Anaesthesia Risk or other short-term insurance)<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-11\" class=\"forminator-field-html forminator-col forminator-col-12  label-hide notes-text form-desc-sm\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-11\"><label class=\"forminator-label\">HTML<\/label><p>When paying quarterly or monthly, a surcharge of 6% will be charged on the annual premium. If you choose to pay your premium quarterly or monthly, direct debit is required. Direct debit is also required for short-term insurance policies (including Transport, Castration, and Anesthesia Risk Insurance).<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-25\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-25_6af5686f0304b\" id=\"forminator-field-text-25_6af5686f0304b-label\" class=\"forminator-label\">IBAN number<\/label><input type=\"text\" name=\"text-25\" value=\"\" placeholder=\"\" id=\"forminator-field-text-25_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-12\" class=\"forminator-field-html forminator-col forminator-col-12  label-hide notes-text form-desc-sm\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-12\"><label class=\"forminator-label\">HTML<\/label><p>By checking &quot;Agree,&quot; you authorize Equipe Paardenverzekeringen, P.O. Box 5, 5165 ZG Waspik (collector ID: NL41ZZZ562661700000), to send direct debit instructions to your bank to debit the premium (including costs and insurance tax) for this requested insurance. You will receive a statement of the debit with the policy, including the authorization reference. If you disagree with this debit, you can have it reversed. To do so, please contact your bank within eight weeks of the debit. You can request the terms and conditions from your bank.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-31\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-31-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-31-6af5686f0304b-label\" class=\"forminator-label\">Agreement with direct debit authorization <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-31-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-31-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Agreement with direct debit authorization\"><input type=\"checkbox\" name=\"checkbox-31[]\" value=\"Akkoord met machtiging voor automatische incasso\" id=\"forminator-field-checkbox-31-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-31-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Agreement with direct debit authorization<\/span><\/label><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-4\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-4-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"4\"\n\t\t\t\tdata-label=\"Dierenarts\"\n\t\t\t\tdata-actual-label=\"Paard &amp; Verzekering\"\n\t\t\t\tdata-name=\"page-break-5\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-26\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-26_6af5686f0304b\" id=\"forminator-field-text-26_6af5686f0304b-label\" class=\"forminator-label\">1. How long have you owned the horse? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-26\" value=\"\" placeholder=\"\" id=\"forminator-field-text-26_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-27\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-27_6af5686f0304b\" id=\"forminator-field-text-27_6af5686f0304b-label\" class=\"forminator-label\">2. Who did you buy the horse from? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-27\" value=\"\" placeholder=\"\" id=\"forminator-field-text-27_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-28\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-28_6af5686f0304b\" id=\"forminator-field-text-28_6af5686f0304b-label\" class=\"forminator-label\">3. What is the purchase price of the horse? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-28\" value=\"\" placeholder=\"\" id=\"forminator-field-text-28_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6af5686f0304b\" id=\"forminator-field-textarea-2_6af5686f0304b-label\" class=\"forminator-label\">4. What level does the horse compete at (is this estimated or based on competition results)?<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_6af5686f0304b\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:40px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-5-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-5-6af5686f0304b-label\" class=\"forminator-label\">5. Has the horse been insured elsewhere in the past?* <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-5\" value=\"Ja\" id=\"forminator-field-radio-5-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-5\" value=\"Nee\" id=\"forminator-field-radio-5-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><label id=\"forminator-field-radio-5-label-3\" for=\"forminator-field-radio-5-3-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"I don&#039;t know\"><input type=\"radio\" name=\"radio-5\" value=\"Weet ik niet\" id=\"forminator-field-radio-5-3-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-5-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">I don&#039;t know<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-29\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-29_6af5686f0304b\" id=\"forminator-field-text-29_6af5686f0304b-label\" class=\"forminator-label\">With which insurer?<\/label><input type=\"text\" name=\"text-29\" value=\"\" placeholder=\"\" id=\"forminator-field-text-29_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-6\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-6-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-6-6af5686f0304b-label\" class=\"forminator-label\">6. Are you the sole owner of the horse? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-6\" value=\"Ja\" id=\"forminator-field-radio-6-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-6\" value=\"Nee\" id=\"forminator-field-radio-6-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-30\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-30_6af5686f0304b\" id=\"forminator-field-text-30_6af5686f0304b-label\" class=\"forminator-label\">Who is the other owner and what is their share in the horse&#039;s ownership?<\/label><input type=\"text\" name=\"text-30\" value=\"\" placeholder=\"\" id=\"forminator-field-text-30_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-3\" class=\"forminator-field-number forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-number-3_6af5686f0304b\" id=\"forminator-field-number-3_6af5686f0304b-label\" class=\"forminator-label\">7. How many horses do you own? <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-3\" value=\"\" placeholder=\"\" id=\"forminator-field-number-3_6af5686f0304b\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-32\" class=\"forminator-field-checkbox forminator-col forminator-col-12\"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-32-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-32-6af5686f0304b-label\" class=\"forminator-label\">8. Has your horse previously been inspected by a veterinarian? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-32-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-32-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Clinical\"><input type=\"checkbox\" name=\"checkbox-32[]\" value=\"Klinisch\" id=\"forminator-field-checkbox-32-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-32-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Clinical<\/span><\/label><label id=\"forminator-field-checkbox-32-2-6af5686f0304b-label\" for=\"forminator-field-checkbox-32-2-6af5686f0304b\" class=\"forminator-checkbox\" title=\"Radiological\"><input type=\"checkbox\" name=\"checkbox-32[]\" value=\"R\u00f6ntgenologisch\" id=\"forminator-field-checkbox-32-2-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-32-2-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Radiological<\/span><\/label><label id=\"forminator-field-checkbox-32-3-6af5686f0304b-label\" for=\"forminator-field-checkbox-32-3-6af5686f0304b\" class=\"forminator-checkbox\" title=\"No\"><input type=\"checkbox\" name=\"checkbox-32[]\" value=\"Nee\" id=\"forminator-field-checkbox-32-3-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-32-3-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-8\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-8-picker_6af5686f0304b\" id=\"forminator-field-date-8-picker_6af5686f0304b-label\" class=\"forminator-label\">Date:<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-8\" value=\"\" placeholder=\"mm\/dd\/yyyy\" id=\"forminator-field-date-8-picker_6af5686f0304b\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-32\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-32_6af5686f0304b\" id=\"forminator-field-text-32_6af5686f0304b-label\" class=\"forminator-label\">Veterinary surgeon:<\/label><input type=\"text\" name=\"text-32\" value=\"\" placeholder=\"\" id=\"forminator-field-text-32_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-5\" class=\"forminator-field-upload forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-upload-5_6af5686f0304b\" id=\"forminator-field-upload-5_6af5686f0304b-label\" class=\"forminator-label\">Please include a copy of the inspection report<\/label><div class=\"forminator-file-upload\" data-element=\"upload-5_6af5686f0304b\"><input type=\"file\" name=\"upload-5\" id=\"forminator-field-upload-5_6af5686f0304b\" class=\"forminator-input-file\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.ico,.heic,.heif,.heics,.heifs,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.flv,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.x-wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mdb,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onetmp,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svgz,.cdr,.ai,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/x-icon,image\/heic,image\/heif,image\/heic-sequence,image\/heif-sequence,video\/x-ms-asf,video\/x-ms-wmv,video\/x-ms-wmx,video\/x-ms-wm,video\/avi,video\/divx,video\/x-flv,video\/quicktime,video\/mpeg,video\/mp4,video\/ogg,video\/webm,video\/x-matroska,video\/3gpp,video\/3gpp2,text\/plain,text\/csv,text\/tab-separated-values,text\/calendar,text\/vtt,audio\/mpeg,audio\/aac,audio\/x-realaudio,audio\/wav,audio\/ogg,audio\/flac,audio\/midi,audio\/x-ms-wma,audio\/x-ms-wax,audio\/x-matroska,application\/rtf,application\/pdf,application\/java,application\/x-tar,application\/zip,application\/x-gzip,application\/x-7z-compressed,application\/octet-stream,application\/msword,application\/vnd.ms-powerpoint,application\/vnd.ms-write,application\/vnd.ms-excel,application\/vnd.ms-access,application\/vnd.ms-project,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.ms-word.document.macroEnabled.12,application\/vnd.openxmlformats-officedocument.wordprocessingml.template,application\/vnd.ms-word.template.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application\/vnd.ms-excel.sheet.macroEnabled.12,application\/vnd.ms-excel.sheet.binary.macroEnabled.12,application\/vnd.openxmlformats-officedocument.spreadsheetml.template,application\/vnd.ms-excel.template.macroEnabled.12,application\/vnd.ms-excel.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.presentation,application\/vnd.ms-powerpoint.presentation.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slideshow,application\/vnd.ms-powerpoint.slideshow.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.template,application\/vnd.ms-powerpoint.template.macroEnabled.12,application\/vnd.ms-powerpoint.addin.macroEnabled.12,application\/vnd.openxmlformats-officedocument.presentationml.slide,application\/vnd.ms-powerpoint.slide.macroEnabled.12,application\/onenote,application\/oxps,application\/vnd.ms-xpsdocument,application\/vnd.oasis.opendocument.text,application\/vnd.oasis.opendocument.presentation,application\/vnd.oasis.opendocument.spreadsheet,application\/vnd.oasis.opendocument.graphics,application\/vnd.oasis.opendocument.chart,application\/vnd.oasis.opendocument.database,application\/vnd.oasis.opendocument.formula,application\/wordperfect,application\/vnd.apple.keynote,application\/vnd.apple.numbers,application\/vnd.apple.pages\" tabindex=\"-1\"><button id=\"forminator-field-upload-5_6af5686f0304b_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-5_6af5686f0304b\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-8\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-8-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-8-6af5686f0304b-label\" class=\"forminator-label\">9. Has an increased risk ever been identified in the horse? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-8-label-1\" for=\"forminator-field-radio-8-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-8\" value=\"Ja\" id=\"forminator-field-radio-8-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-8-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-8-label-2\" for=\"forminator-field-radio-8-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-8\" value=\"Nee\" id=\"forminator-field-radio-8-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-8-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-33\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-33_6af5686f0304b\" id=\"forminator-field-text-33_6af5686f0304b-label\" class=\"forminator-label\">Please explain<\/label><input type=\"text\" name=\"text-33\" value=\"\" placeholder=\"\" id=\"forminator-field-text-33_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-22\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-22-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-22-6af5686f0304b-label\" class=\"forminator-label\">10. Is your horse healthy and in full training? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-22-label-1\" for=\"forminator-field-radio-22-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-22\" value=\"Ja\" id=\"forminator-field-radio-22-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-22-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-22-label-2\" for=\"forminator-field-radio-22-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-22\" value=\"Nee\" id=\"forminator-field-radio-22-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-22-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_6af5686f0304b\" id=\"forminator-field-textarea-3_6af5686f0304b-label\" class=\"forminator-label\">If not, please explain.<\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_6af5686f0304b\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:40px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-9\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-9-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-9-6af5686f0304b-label\" class=\"forminator-label\">11. Is the horse dewormed and vaccinated as prescribed? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-9-label-1\" for=\"forminator-field-radio-9-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-9\" value=\"Ja\" id=\"forminator-field-radio-9-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-9-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-9-label-2\" for=\"forminator-field-radio-9-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-9\" value=\"Nee\" id=\"forminator-field-radio-9-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-9-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-10\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-10-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-10-6af5686f0304b-label\" class=\"forminator-label\">12. Has the horse ever had colic or any other form of stomach or intestinal disorder? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-10-label-1\" for=\"forminator-field-radio-10-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-10\" value=\"Ja\" id=\"forminator-field-radio-10-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-10-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-10-label-2\" for=\"forminator-field-radio-10-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-10\" value=\"Nee\" id=\"forminator-field-radio-10-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-10-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-34\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-34_6af5686f0304b\" id=\"forminator-field-text-34_6af5686f0304b-label\" class=\"forminator-label\">What and when? Was the horse operated on for it?<\/label><input type=\"text\" name=\"text-34\" value=\"\" placeholder=\"\" id=\"forminator-field-text-34_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-11\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-11-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-11-6af5686f0304b-label\" class=\"forminator-label\">13. Has the horse ever been treated by a veterinarian, physiotherapist or homeopath? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-11-label-1\" for=\"forminator-field-radio-11-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-11\" value=\"Ja\" id=\"forminator-field-radio-11-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-11-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-11-label-2\" for=\"forminator-field-radio-11-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-11\" value=\"Nee\" id=\"forminator-field-radio-11-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-11-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-35\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-35_6af5686f0304b\" id=\"forminator-field-text-35_6af5686f0304b-label\" class=\"forminator-label\">What was it for and has the horse fully recovered from it?<\/label><input type=\"text\" name=\"text-35\" value=\"\" placeholder=\"\" id=\"forminator-field-text-35_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-23\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-23-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-23-6af5686f0304b-label\" class=\"forminator-label\">14. Has the horse ever suffered from skin problems, such as tail\/mane eczema, melanomas, or sarcoids? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-23-label-1\" for=\"forminator-field-radio-23-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-23\" value=\"Ja\" id=\"forminator-field-radio-23-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-23-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-23-label-2\" for=\"forminator-field-radio-23-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-23\" value=\"Nee\" id=\"forminator-field-radio-23-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-23-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_6af5686f0304b\" id=\"forminator-field-textarea-4_6af5686f0304b-label\" class=\"forminator-label\">If yes, please explain<\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_6af5686f0304b\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:40px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-13\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-13-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-13-6af5686f0304b-label\" class=\"forminator-label\">15. To your knowledge, has the horse ever had any illness, condition or accident other than those mentioned above? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-13-label-1\" for=\"forminator-field-radio-13-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-13\" value=\"Ja\" id=\"forminator-field-radio-13-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-13-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-13-label-2\" for=\"forminator-field-radio-13-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-13\" value=\"Nee\" id=\"forminator-field-radio-13-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-13-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-37\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-37_6af5686f0304b\" id=\"forminator-field-text-37_6af5686f0304b-label\" class=\"forminator-label\">Please explain:<\/label><input type=\"text\" name=\"text-37\" value=\"\" placeholder=\"\" id=\"forminator-field-text-37_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-14\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-14-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-14-6af5686f0304b-label\" class=\"forminator-label\">16. Has the horse ever shown any abnormality, (stable) vice, resistance, stubbornness or stalling behaviour? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-14-label-1\" for=\"forminator-field-radio-14-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-14\" value=\"Ja\" id=\"forminator-field-radio-14-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-14-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-14-label-2\" for=\"forminator-field-radio-14-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-14\" value=\"Nee\" id=\"forminator-field-radio-14-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-14-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-38\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-38_6af5686f0304b\" id=\"forminator-field-text-38_6af5686f0304b-label\" class=\"forminator-label\">Please explain:<\/label><input type=\"text\" name=\"text-38\" value=\"\" placeholder=\"\" id=\"forminator-field-text-38_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-15\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-15-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-15-6af5686f0304b-label\" class=\"forminator-label\">17. Has there been a contagious disease, infection or other virus at the stable address in the past 12 months? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-15-label-1\" for=\"forminator-field-radio-15-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-15\" value=\"Ja\" id=\"forminator-field-radio-15-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-15-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-15-label-2\" for=\"forminator-field-radio-15-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-15\" value=\"Nee\" id=\"forminator-field-radio-15-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-15-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-39\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-39_6af5686f0304b\" id=\"forminator-field-text-39_6af5686f0304b-label\" class=\"forminator-label\">Please explain:<\/label><input type=\"text\" name=\"text-39\" value=\"\" placeholder=\"\" id=\"forminator-field-text-39_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-16\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-16-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-16-6af5686f0304b-label\" class=\"forminator-label\">18. Are there any other facts that the insurer should know and that may be important for acceptance of the insurance and\/or the insurer&#039;s assessment of the risk? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-16-label-1\" for=\"forminator-field-radio-16-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-16\" value=\"Ja\" id=\"forminator-field-radio-16-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-16-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-16-label-2\" for=\"forminator-field-radio-16-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-16\" value=\"Nee\" id=\"forminator-field-radio-16-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-16-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-40\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-40_6af5686f0304b\" id=\"forminator-field-text-40_6af5686f0304b-label\" class=\"forminator-label\">Please explain:<\/label><input type=\"text\" name=\"text-40\" value=\"\" placeholder=\"\" id=\"forminator-field-text-40_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-5\" class=\"forminator-field-group forminator-col forminator-col-12\"><span id=\"forminator-field-group-5_6af5686f0304b-label\" class=\"forminator-label forminator-repeater-label\">Other circumstances<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\" role=\"group\" aria-labelledby=\"forminator-field-group-5_6af5686f0304b-label\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"radio-18\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-18-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-18-6af5686f0304b-label\" class=\"forminator-label\">Have you or any of the other interested parties ever been confronted with a refusal, cancellation, or acceptance subject to restrictive conditions in relation to an insurance policy such as the one currently applied for? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-18-label-1\" for=\"forminator-field-radio-18-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-18\" value=\"Ja\" id=\"forminator-field-radio-18-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-18-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-18-label-2\" for=\"forminator-field-radio-18-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-18\" value=\"Nee\" id=\"forminator-field-radio-18-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-18-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-41\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-41_6af5686f0304b\" id=\"forminator-field-text-41_6af5686f0304b-label\" class=\"forminator-label\">Please explain<\/label><input type=\"text\" name=\"text-41\" value=\"\" placeholder=\"\" id=\"forminator-field-text-41_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-19\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-19-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-19-6af5686f0304b-label\" class=\"forminator-label\">Have you or any of the other interested parties ever suffered damage to a horse, regardless of whether the horse was insured? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-19-label-1\" for=\"forminator-field-radio-19-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-19\" value=\"Ja\" id=\"forminator-field-radio-19-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-19-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-19-label-2\" for=\"forminator-field-radio-19-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-19\" value=\"Nee\" id=\"forminator-field-radio-19-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-19-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-42\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-42_6af5686f0304b\" id=\"forminator-field-text-42_6af5686f0304b-label\" class=\"forminator-label\">Please explain:<\/label><input type=\"text\" name=\"text-42\" value=\"\" placeholder=\"\" id=\"forminator-field-text-42_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-20\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-20-6af5686f0304b-label\"><span id=\"forminator-radiogroup-radio-20-6af5686f0304b-label\" class=\"forminator-label\">Have you or any of the other interested parties had any contact with the law in the last eight years? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-20-label-1\" for=\"forminator-field-radio-20-1-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-20\" value=\"Ja\" id=\"forminator-field-radio-20-1-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-20-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-20-label-2\" for=\"forminator-field-radio-20-2-6af5686f0304b\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-20\" value=\"Nee\" id=\"forminator-field-radio-20-2-6af5686f0304b\" aria-labelledby=\"forminator-field-radio-20-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-43\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-43_6af5686f0304b\" id=\"forminator-field-text-43_6af5686f0304b-label\" class=\"forminator-label\">Please explain.<\/label><input type=\"text\" name=\"text-43\" value=\"\" placeholder=\"\" id=\"forminator-field-text-43_6af5686f0304b\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-13\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-13\"><p>If you wish, you can send this information confidentially to management.<\/p><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-2717--page-5\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-2717--page-5-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"5\"\n\t\t\t\tdata-label=\"Paard &amp; Verzekering\"\n\t\t\t\tdata-actual-label=\"Page 6\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-14\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-14\"><label class=\"forminator-label\">Final statement<\/label><p>By signing, the applicant declares that the answers provided are correct and complete. The undersigned also declares that they wish to take out insurance as specified above with Equipe Horse Insurance and agrees to the application of the applicable terms and conditions to the requested insurance.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-15\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-15\"><label class=\"forminator-label\">Legal obligation to provide information<\/label><p>You are obligated to answer the questions in this application form as completely as possible. This also applies to facts and circumstances relating to a third party whose interests are co-insured. Furthermore, your answers are not solely based on your own knowledge, but also on that of the other stakeholders in this insurance policy. You must nevertheless answer questions to which you assume the company already has the answers as completely as possible. Failure to comply with your disclosure obligation, or incomplete compliance, may result in the right to payment being limited or even lost, or the insurance being terminated.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-16\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-16\"><label class=\"forminator-label\">Personal data<\/label><p>When applying for insurance, personal data is requested. Equipe Horse Insurance processes this data solely for the purpose of entering into and executing agreements, preventing and combating fraud against financial institutions, for statistical analysis, and to comply with legal obligations.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-17\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-17\"><label class=\"forminator-label\">Complaints bodies<\/label><p>Complaints about the performance of the insurance contract must first be submitted to Equipe Horse Insurance. If the company&#039;s assessment is not satisfactory, you can contact the Financial Services Complaints Institute, which will attempt to resolve the complaint through mediation. If you are not satisfied with the handling of the complaint by the Complaints Institute, please refer to the Complaints Procedure in the Equipe policy conditions.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-18\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-18\"><label class=\"forminator-label\">Dutch law<\/label><p>Dutch law applies to this insurance.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-19\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-19\"><label class=\"forminator-label\">Insurance company \/ risk carrier<\/label><p>This insurance is taken out with Convex Europe SA. Convex Europe SA is a limited liability company registered in the Grand Duchy of Luxembourg with registration number B253295. Its registered address is Convex Europe SA, 37 Boulevard Joseph II, 2nd floor, L-1840 Luxembourg, Grand Duchy of Luxembourg. Convex Europe SA is authorized and supervised by the Commissariat aux Assurances (CAA reference 894500S0IQYVDCWFAR23). All insurance professionals in Luxembourg are required to maintain the confidentiality of information entrusted to them in the exercise of their mandate or as part of their professional duties. Convex Europe SA outsources certain services, activities, or tasks to service providers. This means that conversations, documents, personal data, and confidential information shared by you, your beneficiaries, or any other person acting on your side of the insurance relationship may be shared with these service providers throughout the entire term of the insurance contract. These service providers are bound by professional secrecy or a confidentiality agreement. Further details can be found on the Convex Europe SA website: https:\/\/convexin.com\/location\/luxembourg\/. By signing an application form, entering into an insurance contract, or otherwise discussing the purchase of insurance with Convex Europe SA, you authorize Convex Europe SA to outsource services, activities, and tasks to service providers.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-22\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-22\"><label class=\"forminator-label\">Applied conditions<\/label><p>If our application is accepted by the insurance company, you will have entered into two agreements: an insurance agreement with the insurance company and a contract of assignment with Equipe Horse Insurance. We will carry out this assignment to the best of our ability. However, we will do so under the Equipe Horse Mediation Terms and Conditions. By giving us permission to apply for the insurance(s) in response to this email, you also agree to these Equipe Horse Mediation Terms and Conditions. Therefore, please read these terms and conditions carefully. You can find them via the link in the attachment.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-29\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-29-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-29-6af5686f0304b-label\" class=\"forminator-label\">I agree to the conditions applied <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-29-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-29-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"I agree to the conditions applied\"><input type=\"checkbox\" name=\"checkbox-29[]\" value=\"Ik ga akkoord met de toegepaste voorwaarden\" id=\"forminator-field-checkbox-29-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-29-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">I agree to the conditions applied<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-21\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-21\"><label class=\"forminator-label\">Mediation terms and conditions for Equipe Horse Insurance<\/label><p><a rel=\"noopener\" target=\"_blank\" href=\"https:\/\/equipepaarden.nl\/wp-content\/uploads\/2025\/11\/Bemiddelingsvoorwaarden-Equipe-Paardenverzekeringen-Yellow-Hive.pdf\">Download and view our mediation conditions here<\/a><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-33\" class=\"forminator-field-checkbox forminator-col forminator-col-12  label-hide\"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-33-6af5686f0304b-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-33-6af5686f0304b-label\" class=\"forminator-label\">I agree to the mediation conditions <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-33-1-6af5686f0304b-label\" for=\"forminator-field-checkbox-33-1-6af5686f0304b\" class=\"forminator-checkbox\" title=\"I agree to the mediation conditions\"><input type=\"checkbox\" name=\"checkbox-33[]\" value=\"Ik ga akkoord met de bemiddelingsvoorwaarden\" id=\"forminator-field-checkbox-33-1-6af5686f0304b\" aria-labelledby=\"forminator-field-checkbox-33-1-6af5686f0304b-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">I agree to the mediation conditions<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"signature-1\" class=\"forminator-field-signature forminator-col forminator-col-12\"><div class=\"forminator-field forminator-field-signature\"><label for=\"forminator-field-ctlSignature6af5686f0a1a6\" id=\"forminator-field-ctlSignature6af5686f0a1a6-label\" class=\"forminator-label\">Your online signature<\/label><div class=\"forminator-signature\" data-elementheight=\"180\"><span id=\"ctlSignature6af5686f0a1a6_placeholder\" class=\"forminator-signature--placeholder\" aria-hidden=\"true\">Place your online signature here<\/span><div id=\"ctlSignature6af5686f0a1a6_Container\" class=\"forminator-signature--container\"><canvas id=\"ctlSignature6af5686f0a1a6\" class=\"forminator-signature-canvas\" height=\"180\" tabindex=\"-1\"><p>Your browser does not support e-Signature field.<\/p><\/canvas><\/div><\/div><input type=\"hidden\" name=\"field-signature-1\" value=\"6af5686f0a1a6\" class=\"signature-prefix\"><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-20\" class=\"forminator-field-html forminator-col forminator-col-12\"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-20\"><p>By completing and digitally returning this application form, you declare that the answers provided are complete and correct. You also agree to accept the policy and pay the applicable premium and fees.&nbsp;<\/p><\/div><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled>Send your request<\/button><a href=\"#\" class=\"forminator-save-draft-link disabled\" title=\"Fill in form fields before saving it as a draft\" formnovalidate>Temporarily save your application form<\/a><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"fb479d3267\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/2742\" \/><input type=\"hidden\" name=\"form_id\" value=\"2717\"><input type=\"hidden\" name=\"page_id\" value=\"2742\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/equipepaarden.nl\/en\/aanvraagformulier\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><input type=\"hidden\" name=\"save_draft\" value=\"false\"><input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Complete the application form and receive an immediate quote for your horse insurance with clear coverage and premiums.<\/p>","protected":false},"author":1,"featured_media":1937,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2742","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/pages\/2742","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/comments?post=2742"}],"version-history":[{"count":22,"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/pages\/2742\/revisions"}],"predecessor-version":[{"id":3026,"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/pages\/2742\/revisions\/3026"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/media\/1937"}],"wp:attachment":[{"href":"https:\/\/equipepaarden.nl\/en\/wp-json\/wp\/v2\/media?parent=2742"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}