{"id":3862,"date":"2025-04-28T13:54:04","date_gmt":"2025-04-28T12:54:04","guid":{"rendered":"https:\/\/agenda.frejustoulon.fr\/pelerinages\/?page_id=3862"},"modified":"2026-04-08T10:50:07","modified_gmt":"2026-04-08T09:50:07","slug":"pelerinages-cotignac-demande-dassurance","status":"publish","type":"page","link":"https:\/\/agenda.frejustoulon.fr\/pelerinages\/pelerinages-cotignac-demande-dassurance\/","title":{"rendered":"PELERINAGES COTIGNAC &#8211; DEMANDE D&rsquo;ASSURANCE &#8211; GROUPE DU DIOCESE DE FREJUS TOULON"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-3866\" src=\"https:\/\/agenda.frejustoulon.fr\/pelerinages\/wp-content\/uploads\/sites\/15\/2025\/04\/a7r03864.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https:\/\/agenda.frejustoulon.fr\/pelerinages\/wp-content\/uploads\/sites\/15\/2025\/04\/a7r03864.jpg 2000w, 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Demande de d\u00e9claration d'assurance pour les p\u00e8lerinages vers Cotignac 2026<\/h2>\n                            <p class='gform_description'>Vous organisez un p\u00e8lerinage vers Cotignac : merci d'enregistrer les informations ci-dessous afin que nous puissions assurer votre groupe. Des frais de service s'ajoutent au tarif de l'assurance.  Merci de bien veiller \u00e0 ce que le r\u00e8glement soit fait 1 semaine avant le d\u00e9part. Apr\u00e8s la d\u00e9claration effectu\u00e9e, nous ne pourrons pas retirer des personnes qui annuleraient.<\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_126'  action='\/pelerinages\/wp-json\/wp\/v2\/pages\/3862' data-formid='126' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_126' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_126_5\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations personnelles<\/h3><\/div><div id=\"field_126_42\" class=\"gfield gfield--type-select gfield--input-type-select 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_126_42'>Quel p\u00e8lerinage souhaitez vous assurer ?<\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_126_42' class='large gfield_select'     aria-invalid=\"false\" ><option value='M\u00e8res de famille du 8 au 10 mai 2026 - d\u00e9claration \u00e0 faire avant le jeudi 30 avril' >M\u00e8res de famille du 8 au 10 mai 2026 - d\u00e9claration \u00e0 faire avant le jeudi 30 avril<\/option><option value='M\u00e8res de famille du 5 au 7 juin 2026 - d\u00e9claration \u00e0 faire avant le jeudi 28 mai' >M\u00e8res de famille du 5 au 7 juin 2026 - d\u00e9claration \u00e0 faire avant le jeudi 28 mai<\/option><option value='P\u00e8res de famille du 3 au 5 juillet 2026 - - d\u00e9claration \u00e0 faire avant le jeudi 25 juin' >P\u00e8res de famille du 3 au 5 juillet 2026 - - d\u00e9claration \u00e0 faire avant le jeudi 25 juin<\/option><\/select><\/div><\/div><div id=\"field_126_32\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >ATTENTION SI VOUS VOUS INSCRIVEZ APRES LE JEUDI  15 MAI 2025 \u00e0 14h00 VOTRE GROUPE NE SERA PAS ASSURE. <\/div><div id=\"field_126_36\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >ATTENTION SI VOUS VOUS INSCRIVEZ APRES LE JEUDI  5 JUIN 2025 \u00e0 14h00 VOTRE GROUPE NE SERA PAS ASSURE. <\/div><div id=\"field_126_37\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >ATTENTION SI VOUS VOUS INSCRIVEZ APRES LE JEUDI  12 JUIN 2025 \u00e0 14h00 VOTRE GROUPE NE SERA PAS ASSURE. <\/div><div id=\"field_126_38\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >ATTENTION SI VOUS VOUS INSCRIVEZ APRES LE JEUDI 19 JUIN 2025 \u00e0 14h00 VOTRE GROUPE NE SERA PAS ASSURE. <\/div><div id=\"field_126_39\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >ATTENTION SI VOUS VOUS INSCRIVEZ APRES LE JEUDI 3 JUILLET 2025 \u00e0 14h00 VOTRE GROUPE NE SERA PAS ASSURE. <\/div><div id=\"field_126_1\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_126_1'>Nom du groupe \/ chapitre \/ paroisse<\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_126_1' type='text' value='' class='medium'  aria-describedby=\"gfield_description_126_1\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_126_1'><span style=\"color:red;font-weight:bold\">ATTENTION : nous assurons seulement des groupes qui d\u00e9pendent du Dioc\u00e8se de Fr\u00e9jus Toulon.<\/span><\/div><\/div><div id=\"field_126_40\" 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_126_40'>Provenance du groupe : Ville du dioc\u00e8se<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_126_40' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_126_41\" 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_126_41'>Nom et pr\u00e9nom de la personne qui anime votre p\u00e8lerinage<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_126_41' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_126_2\" class=\"gfield gfield--type-text gfield--input-type-text 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_126_2'>Nom et pr\u00e9nom du responsable de groupe<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_126_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_126_25\" class=\"gfield gfield--type-phone gfield--input-type-phone 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_126_25'>T\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_25' id='input_126_25' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_126_24\" 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_126_24'>E-mail<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_24' id='input_126_24' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_126_27\" class=\"gfield gfield--type-number gfield--input-type-number 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_126_27'>Nombre de p\u00e8lerins<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_27' id='input_126_27' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_126_28\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload 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_126_28'>Liste des p\u00e8lerins avec le nom et pr\u00e9nom de chaque personne (pr\u00eatres et accompagnateurs compris)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1433600' \/><input name='input_28' id='input_126_28' type='file' class='large' aria-describedby=\"gfield_upload_rules_126_28\" onchange='javascript:gformValidateFileSize( this, 1433600 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_126_28'>Taille max. des fichiers\u00a0: 1 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_126_28'><\/div> <\/div><\/div><fieldset id=\"field_126_16\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox 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' >Actualit\u00e9s des p\u00e8lerinages<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_126_16'><div class='gchoice gchoice_126_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='J&#039;accepte que le service dioc\u00e9sain des p\u00e8lerinages m&#039;envoie l&#039;actualit\u00e9 des p\u00e8lerinages du dioc\u00e8se.'  id='choice_126_16_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_126_16_1' id='label_126_16_1' class='gform-field-label gform-field-label--type-inline'>J'accepte que le service dioc\u00e9sain des p\u00e8lerinages m'envoie l'actualit\u00e9 des p\u00e8lerinages du dioc\u00e8se.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_126_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox 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 gfield_label_before_complex' >Conditions g\u00e9n\u00e9rales de participation aux p\u00e8lerinages.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_126_23'><div class='gchoice gchoice_126_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='J&#039;ai pris connaissance et j&#039;accepte les conditions g\u00e9n\u00e9rales de participation.'  id='choice_126_23_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_126_23_1' id='label_126_23_1' class='gform-field-label gform-field-label--type-inline'>J'ai pris connaissance et j'accepte les conditions g\u00e9n\u00e9rales de participation.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_126_20\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required 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' >Protection des Donn\u00e9es.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_20.1' id='input_126_20_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_126_20\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label 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r\u00e9ponse. Vous disposez \u00e9galement du droit de retrait de votre consentement et d\u2019un droit de limitation du traitement.<br \/>\nL\u2019exercice de ces droits peut s\u2019effectuer \u00e0 tout moment aupr\u00e8s de notre Data Protection Officer\u00a0:<br \/>\nSoit par voie \u00e9lectronique\u00a0:\u00a0\u00a0&#x64;&#x70;&#x6f;&#x40;&#x64;&#x69;&#x6f;&#x63;\u00e8&#x73;&#x65;&#x2d;&#x66;&#x72;&#x65;&#x6a;&#x75;&#x73;&#x2d;&#x74;&#x6f;&#x75;&#x6c;&#x6f;&#x6e;&#x2e;&#x63;&#x6f;&#x6d;<br \/>\nSoit par voie postale\u00a0: DPO ADFT Ev\u00e9ch\u00e9 68 impasse de Beaulieu CS 30518\u00a0 <br \/>\n83041 Toulon cedex 9<br \/>\nIl est \u00e9galement rappel\u00e9 que toute personne peut introduire une r\u00e9clamation aupr\u00e8s de l\u2019autorit\u00e9 de contr\u00f4le la CNIL en cas de difficult\u00e9. <br \/>\nPour d\u2019avantage d\u2019informations sur le traitement des donn\u00e9es, vous pouvez consulter sur notre site internet notre charte  https:\/\/frejustoulon.fr\/donnees-personnelles et les conditions g\u00e9n\u00e9rales de ventes, notre attestation assurance responsabilit\u00e9 civile, notre attestation de garantie financi\u00e8re  ainsi que notre agr\u00e9ment au registre des voyages sur notre site internet http:\/\/diocese-frejus-toulon.com\/-Service-des-Pelerinages-.html  ou en faisant la demande par courrier. 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