{"id":2138,"date":"2024-09-19T07:12:33","date_gmt":"2024-09-19T07:12:33","guid":{"rendered":"https:\/\/yachtcharterlemmer.nl\/?page_id=2138"},"modified":"2025-01-22T18:32:00","modified_gmt":"2025-01-22T18:32:00","slug":"offerte","status":"publish","type":"page","link":"https:\/\/yachtcharterlemmer.nl\/offerte\/","title":{"rendered":"offerte aanvragen boot"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\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 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gfield_required_text\">(Vereist)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_2_3' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_3_1_container' >\n                                        <input type='text' name='input_3.1' id='input_2_3_1' value=''    aria-required='true'    \/>\n                                        <label for='input_2_3_1' id='input_2_3_1_label' class='gform-field-label gform-field-label--type-sub '>Straat + huisnummer<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_3_3_container' >\n                                    <input type='text' name='input_3.3' id='input_2_3_3' value=''    aria-required='true'    \/>\n                                    <label for='input_2_3_3' id='input_2_3_3_label' class='gform-field-label gform-field-label--type-sub '>Stad<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_3.4' id='input_2_3_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_2_3_5_container' >\n                                    <input type='text' name='input_3.5' id='input_2_3_5' value=''    aria-required='true'    \/>\n                                    <label for='input_2_3_5' id='input_2_3_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_2_3_6_container' >\n                                        <select name='input_3.6' id='input_2_3_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Aland-eilanden' >Aland-eilanden<\/option><option value='Albani\u00eb' >Albani\u00eb<\/option><option value='Algerije' >Algerije<\/option><option value='Amerikaans Samoa' >Amerikaans Samoa<\/option><option value='Amerikaanse Maagdeneilanden' >Amerikaanse Maagdeneilanden<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua en Barbuda' >Antigua en Barbuda<\/option><option value='Arabische Republiek Syri\u00eb' >Arabische Republiek Syri\u00eb<\/option><option value='Argentini\u00eb' >Argentini\u00eb<\/option><option value='Armeni\u00eb' >Armeni\u00eb<\/option><option value='Aruba' >Aruba<\/option><option value='Australi\u00eb' >Australi\u00eb<\/option><option value='Azerbeidzjan' >Azerbeidzjan<\/option><option value='Bahama&#039;s' >Bahama&#039;s<\/option><option value='Bahrein' >Bahrein<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belgi\u00eb' >Belgi\u00eb<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius en Saba' >Bonaire, Sint Eustatius en Saba<\/option><option value='Bosni\u00eb en Herzegovina' >Bosni\u00eb en Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet eiland' >Bouvet eiland<\/option><option value='Brazili\u00eb' >Brazili\u00eb<\/option><option value='Brits-Indisch oceaan gebied' >Brits-Indisch oceaan gebied<\/option><option value='Britse Maagdeneilanden' >Britse Maagdeneilanden<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgarije' >Bulgarije<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodja' >Cambodja<\/option><option value='Canada' >Canada<\/option><option value='Centraal-Afrikaanse Republiek' >Centraal-Afrikaanse Republiek<\/option><option value='Chili' >Chili<\/option><option value='China' >China<\/option><option value='Cocoseilanden' >Cocoseilanden<\/option><option value='Colombia' >Colombia<\/option><option value='Comoren' >Comoren<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratische Republiek' >Congo, Democratische Republiek<\/option><option value='Cook eilanden' >Cook eilanden<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Denemarken' >Denemarken<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominicaanse Republiek' >Dominicaanse Republiek<\/option><option value='Duitsland' >Duitsland<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypte' >Egypte<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatoriaal-Guinea' >Equatoriaal-Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estland' >Estland<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopi\u00eb' >Ethiopi\u00eb<\/option><option value='Faer\u00f6er' >Faer\u00f6er<\/option><option value='Falkland eilanden' >Falkland eilanden<\/option><option value='Fiji' >Fiji<\/option><option value='Filipijnen' >Filipijnen<\/option><option value='Finland' >Finland<\/option><option value='Frankrijk' >Frankrijk<\/option><option value='Frans Guyana' >Frans Guyana<\/option><option value='Frans-Polynesi\u00eb' >Frans-Polynesi\u00eb<\/option><option value='Franse zuidelijke gebieden' >Franse zuidelijke gebieden<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgi\u00eb' >Georgi\u00eb<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenada' >Grenada<\/option><option value='Griekenland' >Griekenland<\/option><option value='Groenland' >Groenland<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinee' >Guinee<\/option><option value='Guinee-Bissau' >Guinee-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Heard Eiland en McDonald Eilanden' >Heard Eiland en McDonald Eilanden<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongarije' >Hongarije<\/option><option value='IJsland' >IJsland<\/option><option value='Ierland' >Ierland<\/option><option value='India' >India<\/option><option value='Indonesi\u00eb' >Indonesi\u00eb<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Itali\u00eb' >Itali\u00eb<\/option><option value='Ivoorkust' >Ivoorkust<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordani\u00eb' >Jordani\u00eb<\/option><option value='Kaaimaneilanden' >Kaaimaneilanden<\/option><option value='Kaapverdi\u00eb' >Kaapverdi\u00eb<\/option><option value='Kameroen' >Kameroen<\/option><option value='Kazachstan' >Kazachstan<\/option><option value='Kenia' >Kenia<\/option><option value='Kersteiland' >Kersteiland<\/option><option value='Kirgizi\u00eb' >Kirgizi\u00eb<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kleine eilanden van de Verenigde Staten' >Kleine eilanden van de Verenigde Staten<\/option><option value='Koeweit' >Koeweit<\/option><option value='Korea, Democratische Volksrepubliek' >Korea, Democratische Volksrepubliek<\/option><option value='Korea, Republiek van' >Korea, Republiek van<\/option><option value='Kroati\u00eb' >Kroati\u00eb<\/option><option value='Lao Democratische Volksrepubliek' >Lao Democratische Volksrepubliek<\/option><option value='Lesotho' >Lesotho<\/option><option value='Letland' >Letland<\/option><option value='Libanon' >Libanon<\/option><option value='Liberia' >Liberia<\/option><option value='Libi\u00eb' >Libi\u00eb<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Litouwen' >Litouwen<\/option><option value='Luxemburg' >Luxemburg<\/option><option value='Macau' >Macau<\/option><option value='Madagaskar' >Madagaskar<\/option><option value='Malawi' >Malawi<\/option><option value='Maldiven' >Maldiven<\/option><option value='Maleisi\u00eb' >Maleisi\u00eb<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Man' >Man<\/option><option value='Marokko' >Marokko<\/option><option value='Marshalleilanden' >Marshalleilanden<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritani\u00eb' >Mauritani\u00eb<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldavi\u00eb' >Moldavi\u00eb<\/option><option value='Monaco' >Monaco<\/option><option value='Mongoli\u00eb' >Mongoli\u00eb<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibi\u00eb' >Namibi\u00eb<\/option><option value='Nauru' >Nauru<\/option><option value='Nederland' selected='selected'>Nederland<\/option><option value='Nepal' >Nepal<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Nieuw-Caledoni\u00eb' >Nieuw-Caledoni\u00eb<\/option><option value='Nieuw-Zeeland' >Nieuw-Zeeland<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Noord-Macedoni\u00eb' >Noord-Macedoni\u00eb<\/option><option value='Noordelijke Marianen' >Noordelijke Marianen<\/option><option value='Noorwegen' >Noorwegen<\/option><option value='Norfolk eiland' >Norfolk eiland<\/option><option value='Oeganda' >Oeganda<\/option><option value='Oekra\u00efne' >Oekra\u00efne<\/option><option value='Oezbekistan' >Oezbekistan<\/option><option value='Oman' >Oman<\/option><option value='Oostenrijk' >Oostenrijk<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestina, Staat' >Palestina, Staat<\/option><option value='Panama' >Panama<\/option><option value='Papoea-Nieuw-Guinea' >Papoea-Nieuw-Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Polen' >Polen<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Roemeni\u00eb' >Roemeni\u00eb<\/option><option value='Russische Federatie' >Russische Federatie<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Kitts en Nevis' >Saint Kitts en Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Pierre en Miquelon' >Saint Pierre en Miquelon<\/option><option value='Saint Vincent en de Grenadines' >Saint Vincent en de Grenadines<\/option><option value='Salomonseilanden' >Salomonseilanden<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tom\u00e9 en Principe' >Sao Tom\u00e9 en Principe<\/option><option value='Saoedi-Arabi\u00eb' >Saoedi-Arabi\u00eb<\/option><option value='Senegal' >Senegal<\/option><option value='Servi\u00eb' >Servi\u00eb<\/option><option value='Seychellen' >Seychellen<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Sint-Helena, Hemelvaart en Tristan da Cunha' >Sint-Helena, Hemelvaart en Tristan da Cunha<\/option><option value='Sloveni\u00eb' >Sloveni\u00eb<\/option><option value='Slowakije' >Slowakije<\/option><option value='Soedan' >Soedan<\/option><option value='Somali\u00eb' >Somali\u00eb<\/option><option value='Spanje' >Spanje<\/option><option value='Spitsbergen en Jan Mayen' >Spitsbergen en Jan Mayen<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suriname' >Suriname<\/option><option value='Tadzjikistan' >Tadzjikistan<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tanzania, de Verenigde Republiek van' >Tanzania, de Verenigde Republiek van<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad en Tobago' >Trinidad en Tobago<\/option><option value='Tsjaad' >Tsjaad<\/option><option value='Tsjechi\u00eb' >Tsjechi\u00eb<\/option><option value='Tunesi\u00eb' >Tunesi\u00eb<\/option><option value='Turkije' >Turkije<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks- en Caicoseilanden' >Turks- en Caicoseilanden<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Vaticaanstad' >Vaticaanstad<\/option><option value='Venezuela' >Venezuela<\/option><option value='Verenigd Koninkrijk' >Verenigd Koninkrijk<\/option><option value='Verenigde Arabische Emiraten' >Verenigde Arabische Emiraten<\/option><option value='Verenigde Staten' >Verenigde Staten<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis en Futuna' >Wallis en Futuna<\/option><option value='Westelijke Sahara' >Westelijke Sahara<\/option><option value='Wit-Rusland' >Wit-Rusland<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='Zuid Soedan' >Zuid Soedan<\/option><option value='Zuid-Afrika' >Zuid-Afrika<\/option><option value='Zuid-Georgi\u00eb en de Zuidelijke Sandwich eilanden' >Zuid-Georgi\u00eb en de Zuidelijke Sandwich eilanden<\/option><option value='Zweden' >Zweden<\/option><option value='Zwitserland' >Zwitserland<\/option><\/select>\n                                        <label for='input_2_3_6' id='input_2_3_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_2_4\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_4\" ><label class='gfield_label gform-field-label' for='input_2_4'>Geboortedatum<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_2_4' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/jjjj' aria-describedby=\"input_2_4_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_4_date_format' class='screen-reader-text'>MM slash DD slash JJJJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_4' class='gform_hidden' value='https:\/\/yachtcharterlemmer.nl\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_5\" ><label class='gfield_label gform-field-label' for='input_2_5'>Telefoon<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_2_5' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_6\" ><label class='gfield_label gform-field-label' for='input_2_6'>E-mailadres<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_2_6' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_7\" ><label class='gfield_label gform-field-label' for='input_2_7'>Type schip<\/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-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_8\" ><label class='gfield_label gform-field-label' for='input_2_8'>Z-code<\/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-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_9\" ><label class='gfield_label gform-field-label' for='input_2_9'>Start huurperiode (datum\/tijd)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_9' id='input_2_9' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/jjjj' aria-describedby=\"input_2_9_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_9_date_format' class='screen-reader-text'>MM slash DD slash JJJJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_9' class='gform_hidden' value='https:\/\/yachtcharterlemmer.nl\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_2_10\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_10\" ><label class='gfield_label gform-field-label' for='input_2_10'>Eind huurperiode (datum\/tijd)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_10' id='input_2_10' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/jjjj' aria-describedby=\"input_2_10_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_10_date_format' class='screen-reader-text'>MM slash DD slash JJJJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_10' class='gform_hidden' value='https:\/\/yachtcharterlemmer.nl\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_2_11\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_11\" ><label class='gfield_label gform-field-label' for='input_2_11'>Aantal personen \/ kinderen<\/label><div class='ginput_container ginput_container_number'><input name='input_11' id='input_2_11' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_12\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_12\" ><label class='gfield_label gform-field-label' for='input_2_12'>Verklaring omtrent zeil-en vaarervaring<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_2_12' class='textarea large'    placeholder='Geef hier een korte omschrijving van uw ervaring als schipper, met vermelding van de schepen en het vaargebied waar de vaarervaring is opgedaan en een opsomming van de eventueel door U behaalde certificaten \/vaardiploma&#039;s'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_2_14\" 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\"  data-js-reload=\"field_2_14\" ><label class='gfield_label gform-field-label' for='input_2_14'>Afgelegde zeemijlen als schipper<\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_2_14' class='large gfield_select'     aria-invalid=\"false\" ><option value='Geen' >Geen<\/option><option value='Tot 250 mijl' >Tot 250 mijl<\/option><option value='250-500 mijl' >250-500 mijl<\/option><option value='500-1000 mijl' >500-1000 mijl<\/option><option value='Meer dan 1000 mijl' >Meer dan 1000 mijl<\/option><\/select><\/div><\/div><div id=\"field_2_15\" 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\"  data-js-reload=\"field_2_15\" ><label class='gfield_label gform-field-label' for='input_2_15'>Vaardiploma&#039;s<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_2_15' class='large gfield_select'     aria-invalid=\"false\" ><option value='Geen' >Geen<\/option><option value='Vaarbewijs 1' >Vaarbewijs 1<\/option><option value='Vaarbewijs 2' >Vaarbewijs 2<\/option><option value='Theoretische kust navigatie (TKN)' >Theoretische kust navigatie (TKN)<\/option><\/select><\/div><\/div><div id=\"field_2_16\" 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\"  data-js-reload=\"field_2_16\" ><label class='gfield_label gform-field-label' for='input_2_16'>Als schipper gevaren op schepen tot<\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_2_16' class='large gfield_select'     aria-invalid=\"false\" ><option value='8 meter' >8 meter<\/option><option value='9 meter' >9 meter<\/option><option value='10 meter' >10 meter<\/option><option value='11 meter' >11 meter<\/option><option value='12 meter' >12 meter<\/option><option value='13 meter' >13 meter<\/option><option value='14 meter en meer' >14 meter en meer<\/option><\/select><\/div><\/div><fieldset id=\"field_2_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_17\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Vaargebied waar u wilt varen<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_17'><div class='gchoice gchoice_2_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='Friesland'  id='choice_2_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_1' id='label_2_17_1' class='gform-field-label gform-field-label--type-inline'>Friesland<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='Ijsselmeer'  id='choice_2_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_2' id='label_2_17_2' class='gform-field-label gform-field-label--type-inline'>Ijsselmeer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_17_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.3' type='checkbox'  value='Waddenzee'  id='choice_2_17_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_3' id='label_2_17_3' class='gform-field-label gform-field-label--type-inline'>Waddenzee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_17_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.4' type='checkbox'  value='Zeeland'  id='choice_2_17_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_4' id='label_2_17_4' class='gform-field-label gform-field-label--type-inline'>Zeeland<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_17_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.5' type='checkbox'  value='Noordzee (noordzeepakket verplicht)'  id='choice_2_17_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_5' id='label_2_17_5' class='gform-field-label gform-field-label--type-inline'>Noordzee (noordzeepakket verplicht)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_18\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Optie<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_18'><div class='gchoice gchoice_2_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Reddingsvlot (\u20ac95,-) bij Noordzee verplicht'  id='choice_2_18_1'   \/>\n\t\t\t\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'>Reddingsvlot (\u20ac95,-) bij Noordzee verplicht<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_19\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Borgsomverzekering<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_19'><div class='gchoice gchoice_2_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='Ja, ik wil een annuleringsverzekering'  id='choice_2_19_1'   \/>\n\t\t\t\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'>Ja, ik wil een annuleringsverzekering<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='Ja, ik wil een waarborgverzekering afsluiten.(aanvraaglink sturen wij met kontrakt)'  id='choice_2_19_2'   \/>\n\t\t\t\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'>Ja, ik wil een waarborgverzekering afsluiten.(aanvraaglink sturen wij met kontrakt)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='Ja, ik wil ook een bagage-, aansprakelijkheid-, onvoorziene uitgaven- en ongevallen verzekering afsluiten.'  id='choice_2_19_3'   \/>\n\t\t\t\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'>Ja, ik wil ook een bagage-, aansprakelijkheid-, onvoorziene uitgaven- en ongevallen verzekering afsluiten.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='Ik wil dit later beslissen na ontvangst huurkontract , (we sturen standaard de aanvraag formulieren op)'  id='choice_2_19_4'   \/>\n\t\t\t\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'>Ik wil dit later beslissen na ontvangst huurkontract , (we sturen standaard de aanvraag formulieren op)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_20\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_20\" ><label class='gfield_label gform-field-label' for='input_2_20'>Opmerkingen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_2_20' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Versturen'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_2' 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