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| <![CDATA[<div role="form" class="wpcf7" id="wpcf7-f7300-p28-o1" lang="pt-BR" dir="ltr">
<div class="screen-reader-response"></div>
<form action="/amigos-do-segall/#wpcf7-f7300-p28-o1" method="post" class="wpcf7-form" novalidate="novalidate">
<div style="display: none;">
<input type="hidden" name="_wpcf7" value="7300" />
<input type="hidden" name="_wpcf7_version" value="4.9.1" />
<input type="hidden" name="_wpcf7_locale" value="pt_BR" />
<input type="hidden" name="_wpcf7_unit_tag" value="wpcf7-f7300-p28-o1" />
<input type="hidden" name="_wpcf7_container_post" value="28" />
</div>
<div class="vc_row wpb_row vc_inner vc_row-fluid">
<div class="wpb_column vc_column_container vc_col-sm-6">
<div class="vc_column-inner ">
<div class="wpb_wrapper">
<!-- INÍCIO - Item do formulário --><br />
<label> Nome *<br />
<span class="wpcf7-form-control-wrap nome"><input type="text" name="nome" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label><br />
<label> Telefone<br />
<span class="wpcf7-form-control-wrap telefone"><input type="tel" name="telefone" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel" aria-invalid="false" /></span> </label><br />
<!-- FIM - Item do formulário -->
</div></div></div>
<div class="wpb_column vc_column_container vc_col-sm-6">
<div class="vc_column-inner ">
<div class="wpb_wrapper">
<!-- INÍCIO - Item do formulário --><br />
<label> E-mail *<br />
<span class="wpcf7-form-control-wrap email"><input type="email" name="email" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email" aria-required="true" aria-invalid="false" /></span> </label><br />
<label> Celular<br />
<span class="wpcf7-form-control-wrap celular"><input type="tel" name="celular" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel" aria-invalid="false" /></span> </label><br />
<!-- FIM - Item do formulário -->
</div></div></div>
</div>
<div class="vc_row wpb_row vc_inner vc_row-fluid">
<div class="wpb_column vc_column_container vc_col-sm-6">
<div class="vc_column-inner ">
<div class="wpb_wrapper">
<!-- INÍCIO - Item do formulário --><br />
<label> Endereço *<br />
<span class="wpcf7-form-control-wrap endereco"><input type="text" name="endereco" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label></p>
<p> <label> Opções para associar-se *<br />
<span class="wpcf7-form-control-wrap opcoes"><select name="opcoes" class="wpcf7-form-control wpcf7-select wpcf7-validates-as-required" aria-required="true" aria-invalid="false"><option value="Estudante (R$ 100,00 - anual)">Estudante (R$ 100,00 - anual)</option><option value="Colega (R$ 30,00 - mensal | R$ 300,00 anual)">Colega (R$ 30,00 - mensal | R$ 300,00 anual)</option><option value="Colaborador (R$ 55,00 - mensal | R$ 550,00 anual)">Colaborador (R$ 55,00 - mensal | R$ 550,00 anual)</option><option value="Parceiro (R$ 120,00 - mensal | R$ 1.200,00 anual)">Parceiro (R$ 120,00 - mensal | R$ 1.200,00 anual)</option><option value="Patrono (R$ 260,00 - mensal | R$ 2.600,00 anual)">Patrono (R$ 260,00 - mensal | R$ 2.600,00 anual)</option></select></span> </label><br />
<!-- FIM - Item do formulário -->
</div></div></div>
<div class="wpb_column vc_column_container vc_col-sm-6">
<div class="vc_column-inner ">
<div class="wpb_wrapper">
<!-- INÍCIO - Item do formulário --><br />
<label> Complemento<br />
<span class="wpcf7-form-control-wrap complemento"><input type="text" name="complemento" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false" /></span> </label><br />
<label> Forma de pagamento *</label><br />
<span class="wpcf7-form-control-wrap pagamento"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required"><span class="wpcf7-list-item first"><label><input type="checkbox" name="pagamento[]" value="boleto bancário" /><span class="wpcf7-list-item-label">boleto bancário</span></label></span><span class="wpcf7-list-item"><label><input type="checkbox" name="pagamento[]" value="presencial" /><span class="wpcf7-list-item-label">presencial</span></label></span><span class="wpcf7-list-item"><label><input type="checkbox" name="pagamento[]" value="cartão de crédito" /><span class="wpcf7-list-item-label">cartão de crédito</span></label></span><span class="wpcf7-list-item last"><label><input type="checkbox" name="pagamento[]" value="transferência bancária" /><span class="wpcf7-list-item-label">transferência bancária</span></label></span></span></span><br />
<!-- FIM - Item do formulário -->
</div></div></div>
</div>
<div class="vc_row wpb_row vc_inner vc_row-fluid">
<div class="wpb_column vc_column_container vc_col-sm-12">
<div class="vc_column-inner ">
<div class="wpb_wrapper">
<!-- INÍCIO - Item do formulário --><br />
<label>
<div class="wpcf7-form-control-wrap"><div data-sitekey="6Lenh2MUAAAAAI4Ii5G66PL8FLSQ0OywKerikhKP" class="wpcf7-form-control g-recaptcha wpcf7-recaptcha"></div>
<noscript>
<div style="width: 302px; height: 422px;">
<div style="width: 302px; height: 422px; position: relative;">
<div style="width: 302px; height: 422px; position: absolute;">
<iframe src="https://www.google.com/recaptcha/api/fallback?k=6Lenh2MUAAAAAI4Ii5G66PL8FLSQ0OywKerikhKP" frameborder="0" scrolling="no" style="width: 302px; height:422px; border-style: none;">
</iframe>
</div>
<div style="width: 300px; height: 60px; border-style: none; bottom: 12px; left: 25px; margin: 0px; padding: 0px; right: 25px; background: #f9f9f9; border: 1px solid #c1c1c1; border-radius: 3px;">
<textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid #c1c1c1; margin: 10px 25px; padding: 0px; resize: none;">
</textarea>
</div>
</div>
</div>
</noscript>
</div>
<p> </label><br />
<label> <input type="submit" value="Enviar" class="wpcf7-form-control wpcf7-submit" /> </label><br />
<!-- FIM - Item do formulário -->
</div></div></div>
</div>
<div class="wpcf7-response-output wpcf7-display-none"></div></form></div>]]>
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