<!-- Begin MailChimp Signup Form --><!-- [et_pb_line_break_holder] --><link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css"><!-- [et_pb_line_break_holder] --><style type="text/css"><!-- [et_pb_line_break_holder] --> #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }<!-- [et_pb_line_break_holder] --> /* Add your own MailChimp form style overrides in your site stylesheet or in this style block.<!-- [et_pb_line_break_holder] --> We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */<!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --><style type="text/css"><!-- [et_pb_line_break_holder] --> #mc-embedded-subscribe-form input[type=checkbox]{display: inline; width: auto;margin-right: 10px;}<!-- [et_pb_line_break_holder] --> #mergeRow-gdpr {margin-top: 20px;}<!-- [et_pb_line_break_holder] --> #mergeRow-gdpr fieldset label {font-weight: normal;}<!-- [et_pb_line_break_holder] --> #mc-embedded-subscribe-form .mc_fieldset{border:none;min-height: 0px;padding-bottom:0px;}<!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --><div id="mc_embed_signup"><!-- [et_pb_line_break_holder] --><form action="https://flowingmountains.us18.list-manage.com/subscribe/post?u=89f26371eaa8d45b249b75f20&id=552e5672a4" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate><!-- [et_pb_line_break_holder] --> <div id="mc_embed_signup_scroll"><!-- [et_pb_line_break_holder] --> <h2>Subscribe to our mailing list</h2><!-- [et_pb_line_break_holder] --><div class="indicates-required"><span class="asterisk">*</span> indicates required</div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-FNAME">Voornaam <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="FNAME" class="required" id="mce-FNAME"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-LNAME">Achternaam <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="LNAME" class="required" id="mce-LNAME"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-EMAIL">E-mailadres <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group size1of2"><!-- [et_pb_line_break_holder] --> <label for="mce-PHONE">Telefoonnummer <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" name="PHONE" class="required" value="" id="mce-PHONE"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-MMERGE3">Adres <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="MMERGE3" class="required" id="mce-MMERGE3"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-MMERGE5">Postcode <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="MMERGE5" class="required" id="mce-MMERGE5"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-MMERGE6">Woonplaats <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="MMERGE6" class="required" id="mce-MMERGE6"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group"><!-- [et_pb_line_break_holder] --> <label for="mce-MMERGE9">Bericht </label><!-- [et_pb_line_break_holder] --> <input type="text" value="" name="MMERGE9" class="" id="mce-MMERGE9"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group input-group"><!-- [et_pb_line_break_holder] --> <strong>ja, ik ga akkoord met de: <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></strong><!-- [et_pb_line_break_holder] --> <ul><li><input type="radio" value="Privacyverklaring (zie footer website)" name="MMERGE7" id="mce-MMERGE7-0"><label for="mce-MMERGE7-0">Privacyverklaring (zie footer website)</label></li><!-- [et_pb_line_break_holder] --></ul><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group input-group"><!-- [et_pb_line_break_holder] --> <strong>Alsmede onze <span class="asterisk">*</span><!-- [et_pb_line_break_holder] --></strong><!-- [et_pb_line_break_holder] --> <ul><li><input type="radio" value="Algemene voorwaarden (zie footer website)" name="MMERGE8" id="mce-MMERGE8-0"><label for="mce-MMERGE8-0">Algemene voorwaarden (zie footer website)</label></li><!-- [et_pb_line_break_holder] --></ul><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><div class="mc-field-group input-group"><!-- [et_pb_line_break_holder] --> <strong>Ik schrijf mij in voor: </strong><!-- [et_pb_line_break_holder] --> <ul><li><input type="checkbox" value="16" name="group[4957][16]" id="mce-group[4957]-4957-0"><label for="mce-group[4957]-4957-0">Breintraining</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="8" name="group[4957][8]" id="mce-group[4957]-4957-1"><label for="mce-group[4957]-4957-1">Individueel traject Mindfulness</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="1" name="group[4957][1]" id="mce-group[4957]-4957-2"><label for="mce-group[4957]-4957-2">Kennismakingsworkshop Mindfulness Elst</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="2" name="group[4957][2]" id="mce-group[4957]-4957-3"><label for="mce-group[4957]-4957-3">Mindfulness di-av Elst</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="4" name="group[4957][4]" id="mce-group[4957]-4957-4"><label for="mce-group[4957]-4957-4">Zen do-av Oosterbeek</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="32" name="group[4957][32]" id="mce-group[4957]-4957-5"><label for="mce-group[4957]-4957-5">Kennismakingsworkshop Mindfulness Schijndel</label></li><!-- [et_pb_line_break_holder] --><li><input type="checkbox" value="64" name="group[4957][64]" id="mce-group[4957]-4957-6"><label for="mce-group[4957]-4957-6">Mindfulness wo-av Schijndel</label></li><!-- [et_pb_line_break_holder] -->