{"id":3287,"date":"2022-10-17T10:13:18","date_gmt":"2022-10-17T10:13:18","guid":{"rendered":"https:\/\/ecdf.be\/about-safety\/take-me-to-the-online-reporting-tool\/"},"modified":"2022-11-24T11:34:02","modified_gmt":"2022-11-24T11:34:02","slug":"take-me-to-the-online-reporting-tool","status":"publish","type":"page","link":"https:\/\/ecdf.be\/en\/about-us\/about-safety\/take-me-to-the-online-reporting-tool\/","title":{"rendered":"Take me to the online reporting tool"},"content":{"rendered":"<section class=\"b-form bg-none\">\n\t<div>\n\t\t<div class=\"b-form-head\">\n\t\t\t<h3>Online form accidents<\/h3>            \t\t<\/div>\n\t\t<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/en\/wp-json\/wp\/v2\/pages\/3287' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_13'>Name member<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_2_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_14'>Afge of the student<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_2_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Sex (at birth)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_16'>\n\t\t\t<div class='gchoice gchoice_2_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='M'  id='choice_2_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_16_0' id='label_2_16_0' class='gform-field-label gform-field-label--type-inline'>M<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='F'  id='choice_2_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_16_1' id='label_2_16_1' class='gform-field-label gform-field-label--type-inline'>F<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='X'  id='choice_2_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_16_2' id='label_2_16_2' class='gform-field-label gform-field-label--type-inline'>X<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_16_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='I&#039;d rather not share this info'  id='choice_2_16_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_16_3' id='label_2_16_3' class='gform-field-label gform-field-label--type-inline'>I&#8217;d rather not share this info<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_20'>\n\t\t\t<div class='gchoice gchoice_2_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='M'  id='choice_2_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_0' id='label_2_20_0' class='gform-field-label gform-field-label--type-inline'>M<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='F'  id='choice_2_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_1' id='label_2_20_1' class='gform-field-label gform-field-label--type-inline'>F<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='X'  id='choice_2_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_2' id='label_2_20_2' class='gform-field-label gform-field-label--type-inline'>X<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='I&#039;d rather not share this info'  id='choice_2_20_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_3' id='label_2_20_3' class='gform-field-label gform-field-label--type-inline'>I&#8217;d rather not share this info<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_3'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_2_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_2_4\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Date of the accident<\/legend><div id='input_2_4' class='ginput_container ginput_complex gform-grid-row'>\n                                        <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_2_4_2_container'>\n                                            <input type='number' maxlength='2' name='input_4[]' id='input_2_4_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_2_4_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_2_4_1_container'>\n                                        <input type='number' maxlength='2' name='input_4[]' id='input_2_4_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_2_4_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                   <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_2_4_3_container'>\n                                        <input type='number' maxlength='4' name='input_4[]' id='input_2_4_3' value=''   aria-required='false'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                        <label for='input_2_4_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                   <\/div>\n                                <\/div><\/fieldset><div id=\"field_2_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'>During which class did you suffer the injury? Be sure to include the time and location.<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_2_5' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_6'>Which trainers were present?<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_2_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >At what point did you sustain the injury?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_19'>\n\t\t\t<div class='gchoice gchoice_2_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='During warm-up'  id='choice_2_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_0' id='label_2_19_0' class='gform-field-label gform-field-label--type-inline'>During warm-up<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='At the beginning of the training'  id='choice_2_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_1' id='label_2_19_1' class='gform-field-label gform-field-label--type-inline'>At the beginning of the training<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='In the middle of the training'  id='choice_2_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_2' id='label_2_19_2' class='gform-field-label gform-field-label--type-inline'>In the middle of the training<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='At the end of the training'  id='choice_2_19_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_3' id='label_2_19_3' class='gform-field-label gform-field-label--type-inline'>At the end of the training<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='During a performance'  id='choice_2_19_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_4' id='label_2_19_4' class='gform-field-label gform-field-label--type-inline'>During a performance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Not circus-related\/transportation'  id='choice_2_19_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_5' id='label_2_19_5' class='gform-field-label gform-field-label--type-inline'>Not circus-related\/transportation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='In between (while cleaning up)'  id='choice_2_19_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_6' id='label_2_19_6' class='gform-field-label gform-field-label--type-inline'>In between (while cleaning up)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='gf_other_choice'  id='choice_2_19_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_7' id='label_2_19_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_2_19_other' class='gchoice_other_control' name='input_19_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What discipline was the student performing at the time of the accident (make a choice)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_25'>\n\t\t\t<div class='gchoice gchoice_2_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Floor acrobatics'  id='choice_2_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_0' id='label_2_25_0' class='gform-field-label gform-field-label--type-inline'>Floor acrobatics<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Acro-port\u00e9'  id='choice_2_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_1' id='label_2_25_1' class='gform-field-label gform-field-label--type-inline'>Acro-port\u00e9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Teeterboard'  id='choice_2_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_2' id='label_2_25_2' class='gform-field-label gform-field-label--type-inline'>Teeterboard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Trampoline'  id='choice_2_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_3' id='label_2_25_3' class='gform-field-label gform-field-label--type-inline'>Trampoline<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Aerial acro (trapeze, silks, pole, rope, hoop)'  id='choice_2_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_4' id='label_2_25_4' class='gform-field-label gform-field-label--type-inline'>Aerial acro (trapeze, silks, pole, rope, hoop)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Balance (ball\/barrel\/rope\/ unicycle)'  id='choice_2_25_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_5' id='label_2_25_5' class='gform-field-label gform-field-label--type-inline'>Balance (ball\/barrel\/rope\/ unicycle)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Cyr wheel\/German wheel'  id='choice_2_25_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_6' id='label_2_25_6' class='gform-field-label gform-field-label--type-inline'>Cyr wheel\/German wheel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Appliance acro (skirting\/mat\/bench\/parkour)'  id='choice_2_25_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_7' id='label_2_25_7' class='gform-field-label gform-field-label--type-inline'>Appliance acro (skirting\/mat\/bench\/parkour)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_25_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gf_other_choice'  id='choice_2_25_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_25_8' id='label_2_25_8' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_2_25_other' class='gchoice_other_control' name='input_25_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Were you warmed up at the time of the injury?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_26'>\n\t\t\t<div class='gchoice gchoice_2_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Yes'  id='choice_2_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_0' id='label_2_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='No'  id='choice_2_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_1' id='label_2_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_7'>Briefly describe the injury you sustained. What happened?<\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_2_7' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_8'>How did you suffer this injury? Briefly describe the accident.<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_2_8' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_9'>What steps were taken. What care was needed (ice, bandages, emergency&#8230;)?<\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_2_9' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_10'>As a result of your injury, will you not be able to come to classes or exercise for some time? If so, has your doctor given you an indication of when you can start training again? We ask this in order to assess the severity of the injury.<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_2_10' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_31'>Have you ever had a similar injury in the past?<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_2_31' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >On average, how often do you train per week? We ask this to get an idea of the relationship between number of hours of training and whether or not injuries occur.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_18'>\n\t\t\t<div class='gchoice gchoice_2_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='0 to 2 hours per week'  id='choice_2_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_0' id='label_2_18_0' class='gform-field-label gform-field-label--type-inline'>0 to 2 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='2 to 6 hours per week'  id='choice_2_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_1' id='label_2_18_1' class='gform-field-label gform-field-label--type-inline'>2 to 6 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='6 to 10 hours per week'  id='choice_2_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_2' id='label_2_18_2' class='gform-field-label gform-field-label--type-inline'>6 to 10 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='More than 10 hours per week'  id='choice_2_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_3' id='label_2_18_3' class='gform-field-label gform-field-label--type-inline'>More than 10 hours per week<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How many hours did you train in the past week?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_24'>\n\t\t\t<div class='gchoice gchoice_2_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='0 to 2 hours'  id='choice_2_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_0' id='label_2_24_0' class='gform-field-label gform-field-label--type-inline'>0 to 2 hours<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='2 to 6 hours'  id='choice_2_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_1' id='label_2_24_1' class='gform-field-label gform-field-label--type-inline'>2 to 6 hours<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='6 to 10 hours'  id='choice_2_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_2' id='label_2_24_2' class='gform-field-label gform-field-label--type-inline'>6 to 10 hours<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='More than 10 hours'  id='choice_2_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_3' id='label_2_24_3' class='gform-field-label gform-field-label--type-inline'>More than 10 hours<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Apart from your circus training, do you do any other sport activities? If so, how much time do these take up on average per week?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_22'>\n\t\t\t<div class='gchoice gchoice_2_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='0 to 2 hours per week'  id='choice_2_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_0' id='label_2_22_0' class='gform-field-label gform-field-label--type-inline'>0 to 2 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='2 to 6 hours per week'  id='choice_2_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_1' id='label_2_22_1' class='gform-field-label gform-field-label--type-inline'>2 to 6 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='6 to 10 hours per week'  id='choice_2_22_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_2' id='label_2_22_2' class='gform-field-label gform-field-label--type-inline'>6 to 10 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='More than 10 hours per week'  id='choice_2_22_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_3' id='label_2_22_3' class='gform-field-label gform-field-label--type-inline'>More than 10 hours per week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Other than circus, I don&#039;t do any other sports'  id='choice_2_22_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_4' id='label_2_22_4' class='gform-field-label gform-field-label--type-inline'>Other than circus, I don&#8217;t do any other sports<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >At the time of the accident, were you training for an audition or performance?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_23'>\n\t\t\t<div class='gchoice gchoice_2_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes, for an audition'  id='choice_2_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_0' id='label_2_23_0' class='gform-field-label gform-field-label--type-inline'>Yes, for an audition<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes, for a performance'  id='choice_2_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_1' id='label_2_23_1' class='gform-field-label gform-field-label--type-inline'>Yes, for a performance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_2_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_2' id='label_2_23_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='gf_other_choice'  id='choice_2_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_23_3' id='label_2_23_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_2_23_other' class='gchoice_other_control' name='input_23_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Were there any additional stress factors at the time of the accident that put extra pressure on you and your health?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_35'>\n\t\t\t<div class='gchoice gchoice_2_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Physical - e.g., more exercise than usual, illness, lack of sleep, hormonal\/physical changes, unhealthy diet'  id='choice_2_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_0' id='label_2_35_0' class='gform-field-label gform-field-label--type-inline'>Physical &#8211; e.g., more exercise than usual, illness, lack of sleep, hormonal\/physical changes, unhealthy diet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Emotional - e.g., exam period, arguments, recent death.'  id='choice_2_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_1' id='label_2_35_1' class='gform-field-label gform-field-label--type-inline'>Emotional &#8211; e.g., exam period, arguments, recent death.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Social - e.g., peer pressure, bullying.'  id='choice_2_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_2' id='label_2_35_2' class='gform-field-label gform-field-label--type-inline'>Social &#8211; e.g., peer pressure, bullying.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='No, nothing wrong!'  id='choice_2_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_3' id='label_2_35_3' class='gform-field-label gform-field-label--type-inline'>No, nothing wrong!<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='gf_other_choice'  id='choice_2_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_4' id='label_2_35_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_2_35_other' class='gchoice_other_control' name='input_35_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you suffered any form of brain trauma in the past year? Concussion, whiplash, excessive alcohol consumption (memory loss)&#8230;<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_36'>\n\t\t\t<div class='gchoice gchoice_2_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Yes'  id='choice_2_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_0' id='label_2_36_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='No'  id='choice_2_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_1' id='label_2_36_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Yes, that would be nice<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_28'>\n\t\t\t<div class='gchoice gchoice_2_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Ja, graag'  id='choice_2_28_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_28\"   \/>\n\t\t\t\t\t<label for='choice_2_28_0' id='label_2_28_0' class='gform-field-label gform-field-label--type-inline'>Ja, graag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No, that&#039;s not necessary'  id='choice_2_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_28_1' id='label_2_28_1' class='gform-field-label gform-field-label--type-inline'>No, that&#8217;s not necessary<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_2_28'>Je kan ook zelf onze API&#8217;s bereiken via line@ecdf.be, an.api@ecdf.be of niels.api@ecdf.be<\/div><\/fieldset><fieldset id=\"field_2_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you give us permission to discuss this accident with the members of our SAFE team and, if necessary, with the trainers? This will be done anonymously to the extent possible.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_27'>\n\t\t\t<div class='gchoice gchoice_2_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Yeah, sure! Be my guest.'  id='choice_2_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_27_0' id='label_2_27_0' class='gform-field-label gform-field-label--type-inline'>Yeah, sure! Be my guest.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='No, I would rather not'  id='choice_2_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_27_1' id='label_2_27_1' class='gform-field-label gform-field-label--type-inline'>No, I would rather not<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Ernstige blessures volgen we graag grondig op. Mogen we jou over enkele weken even opnieuw contacteren om te horen hoe het gaat?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_30'>\n\t\t\t<div class='gchoice gchoice_2_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Ja, doe maar!'  id='choice_2_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_0' id='label_2_30_0' class='gform-field-label gform-field-label--type-inline'>Ja, doe maar!<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Nee, liever niet'  id='choice_2_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_1' id='label_2_30_1' class='gform-field-label gform-field-label--type-inline'>Nee, liever niet<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_29\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Data processing<\/legend><div class='ginput_container ginput_container_consent'><input name='input_29.1' id='input_2_29_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_2_29\"  aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_29_1' >I authorize Ell Circo D&#8217;ell Fuego to keep and process the above data as part of the organization&#8217;s safety policy.<\/label><input type='hidden' name='input_29.2' value='I authorize Ell Circo D&#039;ell Fuego to keep and process the above data as part of the organization&#039;s safety policy.' class='gform_hidden' \/><input type='hidden' name='input_29.3' value='6' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_2_29' tabindex='0'>We use the data you share with us to monitor and &#8211; where necessary &#8211; adjust our safety policy. 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