{"id":4166,"date":"2026-07-01T11:25:41","date_gmt":"2026-07-01T09:25:41","guid":{"rendered":"https:\/\/muetterberatung-bl-bs.ch\/2\/?page_id=4166"},"modified":"2026-07-01T11:27:06","modified_gmt":"2026-07-01T09:27:06","slug":"uebergabeformular-fuer-gemeinden","status":"publish","type":"page","link":"https:\/\/muetterberatung-bl-bs.ch\/2\/uebergabeformular-fuer-gemeinden\/","title":{"rendered":"\u00dcbergabeformular f\u00fcr Gemeinden"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1331.2px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:20px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><div id=\"quform-0da508\" class=\"quform quform-3 quform-support-page-caching\"><form id=\"quform-form-0da508\" class=\"quform-form quform-form-3\" action=\"\/2\/wp-json\/wp\/v2\/pages\/4166#quform-0da508\" method=\"post\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-options=\"{&quot;id&quot;:3,&quot;uniqueId&quot;:&quot;0da508&quot;,&quot;theme&quot;:&quot;&quot;,&quot;ajax&quot;:true,&quot;logic&quot;:{&quot;logic&quot;:{&quot;17&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;145&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;5&quot;,&quot;value&quot;:&quot;Andere&quot;}]},&quot;179&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;178&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;5&quot;,&quot;value&quot;:&quot;Andere&quot;}]}},&quot;dependents&quot;:{&quot;145&quot;:[17],&quot;178&quot;:[179]},&quot;elementIds&quot;:[17,179],&quot;dependentElementIds&quot;:[&quot;145&quot;,&quot;178&quot;],&quot;animate&quot;:true},&quot;currentPageId&quot;:1,&quot;errorsIcon&quot;:&quot;&quot;,&quot;updateFancybox&quot;:true,&quot;hasPages&quot;:false,&quot;pages&quot;:[1],&quot;pageProgressType&quot;:&quot;numbers&quot;,&quot;tooltipsEnabled&quot;:true,&quot;tooltipClasses&quot;:&quot;qtip-quform-dark qtip-shadow&quot;,&quot;tooltipMy&quot;:&quot;left center&quot;,&quot;tooltipAt&quot;:&quot;right center&quot;,&quot;isRtl&quot;:false,&quot;scrollOffset&quot;:-50,&quot;scrollSpeed&quot;:800}\"><button class=\"quform-default-submit\" name=\"quform_submit\" type=\"submit\" value=\"submit\" aria-hidden=\"true\" tabindex=\"-1\"><\/button><div class=\"quform-form-inner quform-form-inner-3\"><input type=\"hidden\" name=\"quform_form_id\" value=\"3\" \/><input type=\"hidden\" name=\"quform_form_uid\" value=\"0da508\" \/><input type=\"hidden\" name=\"quform_count\" value=\"1\" \/><input type=\"hidden\" name=\"form_url\" value=\"https:\/\/muetterberatung-bl-bs.ch\/2\/wp-json\/wp\/v2\/pages\/4166\" \/><input type=\"hidden\" name=\"referring_url\" value=\"\" \/><input type=\"hidden\" name=\"post_id\" value=\"\" \/><input type=\"hidden\" name=\"post_title\" value=\"\" \/><input type=\"hidden\" name=\"quform_current_page_id\" value=\"1\" \/><input type=\"hidden\" name=\"quform_loaded\" value=\"1794235457|9a85a5240c039988f78261001a90973f\" \/><div class=\"quform-form-title-description\"><span class=\"quform-form-title\">Dieses Formular steht den Einwohnergemeinden der Kantone BL, BS und SO zur Verf\u00fcgung, um Geburten und Neuzuz\u00fcge direkt der zust\u00e4ndigen M\u00fctter- und V\u00e4terberatung zu melden.<\/span><\/div><div class=\"quform-elements quform-elements-3 quform-cf quform-responsive-elements-phone-landscape\"><div class=\"quform-element quform-element-page quform-page-1 quform-page-3_1 quform-cf quform-group-style-plain quform-first-page quform-last-page quform-current-page\"><div class=\"quform-child-elements\"><div class=\"quform-element quform-element-html quform-element-3_8 quform-cf\"><div class=\"quform-spacer\"><h3>Personalien Mutter<\/h3><\/div><\/div><div class=\"quform-element quform-element-row quform-element-row-3_9 quform-2-columns quform-element-row-size-fixed quform-responsive-columns-phone-landscape\"><div class=\"quform-element quform-element-column quform-element-3_10\"><div class=\"quform-element quform-element-text quform-element-3_12 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_12\"><label class=\"quform-label-text\" for=\"quform_3_12_0da508\">Vorname Mutter<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_12\"><div class=\"quform-input quform-input-text quform-input-3_12 quform-cf\"><input type=\"text\" id=\"quform_3_12_0da508\" name=\"quform_3_12\" class=\"quform-field quform-field-text quform-field-3_12\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_14 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_14\"><label class=\"quform-label-text\" for=\"quform_3_14_0da508\">Name Mutter<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_14\"><div class=\"quform-input quform-input-text quform-input-3_14 quform-cf\"><input type=\"text\" id=\"quform_3_14_0da508\" name=\"quform_3_14\" class=\"quform-field quform-field-text quform-field-3_14\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_26 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_26\"><label class=\"quform-label-text\" for=\"quform_3_26_0da508\">Telefon<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_26\"><div class=\"quform-input quform-input-text quform-input-3_26 quform-cf\"><input type=\"text\" id=\"quform_3_26_0da508\" name=\"quform_3_26\" class=\"quform-field quform-field-text quform-field-3_26\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-email quform-element-3_40 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_40\"><label class=\"quform-label-text\" for=\"quform_3_40_0da508\">Email<\/label><\/div><div class=\"quform-inner quform-inner-email quform-inner-3_40\"><div class=\"quform-input quform-input-email quform-input-3_40 quform-cf\"><input type=\"email\" id=\"quform_3_40_0da508\" name=\"quform_3_40\" class=\"quform-field quform-field-email quform-field-3_40\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-column quform-element-3_11\"><div class=\"quform-element quform-element-text quform-element-3_27 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_27\"><label class=\"quform-label-text\" for=\"quform_3_27_0da508\">Strasse und Nr.<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_27\"><div class=\"quform-input quform-input-text quform-input-3_27 quform-cf\"><input type=\"text\" id=\"quform_3_27_0da508\" name=\"quform_3_27\" class=\"quform-field quform-field-text quform-field-3_27\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-select quform-element-3_36 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_36\"><label class=\"quform-label-text\" for=\"quform_3_36_0da508\">PLZ + Ort<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-3_36\"><div class=\"quform-input quform-input-select quform-input-3_36 quform-cf\"><select id=\"quform_3_36_0da508\" name=\"quform_3_36\" class=\"quform-field quform-field-select quform-field-3_36\"><option value=\"\" selected=\"selected\">Bitte ausw\u00e4hlen<\/option><option value=\"4147 Aesch\">4147 Aesch<\/option><option value=\"4123 Allschwil\">4123 Allschwil<\/option><option value=\"4469 Anwil\">4469 Anwil<\/option><option value=\"4424 Arboldswil\">4424 Arboldswil<\/option><option value=\"4422 Arisdorf\">4422 Arisdorf<\/option><option value=\"4144 Arlesheim\">4144 Arlesheim<\/option><option value=\"4302 Augst\">4302 Augst<\/option><option value=\"4252 B\u00e4rschwil\">4252 B\u00e4rschwil<\/option><option value=\"4001 Basel\">4001 Basel<\/option><option value=\"4051 Basel\">4051 Basel<\/option><option value=\"4052 Basel\">4052 Basel<\/option><option value=\"4053 Basel\">4053 Basel<\/option><option value=\"4054 Basel\">4054 Basel<\/option><option value=\"4055 Basel\">4055 Basel<\/option><option value=\"4056 Basel\">4056 Basel<\/option><option value=\"4057 Basel\">4057 Basel<\/option><option value=\"4058 Basel\">4058 Basel<\/option><option value=\"4059 Basel\">4059 Basel<\/option><option value=\"4112 B\u00e4ttwil\">4112 B\u00e4ttwil<\/option><option value=\"4229 Beinwil\">4229 Beinwil<\/option><option value=\"4431 Bennwil\">4431 Bennwil<\/option><option value=\"4126 Bettingen\">4126 Bettingen<\/option><option value=\"4105 Biel-Benken\">4105 Biel-Benken<\/option><option value=\"4102 Binningen\">4102 Binningen<\/option><option value=\"4127 Birsfelden\">4127 Birsfelden<\/option><option value=\"4223 Blauen\">4223 Blauen<\/option><option value=\"4461 B\u00f6ckten\">4461 B\u00f6ckten<\/option><option value=\"4103 Bottmingen\">4103 Bottmingen<\/option><option value=\"4226 Breitenbach\">4226 Breitenbach<\/option><option value=\"4207 Bretzwil\">4207 Bretzwil<\/option><option value=\"4225 Brislach\">4225 Brislach<\/option><option value=\"4416 Bubendorf\">4416 Bubendorf<\/option><option value=\"4446 Buckten\">4446 Buckten<\/option><option value=\"4413 B\u00fcren\">4413 B\u00fcren<\/option><option value=\"4117 Burg\">4117 Burg<\/option><option value=\"4227 B\u00fcsserach\">4227 B\u00fcsserach<\/option><option value=\"4463 Buus\">4463 Buus<\/option><option value=\"4457 Diegten\">4457 Diegten<\/option><option value=\"4442 Diepflingen\">4442 Diepflingen<\/option><option value=\"4243 Dittingen\">4243 Dittingen<\/option><option value=\"4143 Dornach\">4143 Dornach<\/option><option value=\"4202 Duggingen\">4202 Duggingen<\/option><option value=\"4458 Eptingen\">4458 Eptingen<\/option><option value=\"4228 Erschwil\">4228 Erschwil<\/option><option value=\"4107 Ettingen\">4107 Ettingen<\/option><option value=\"4232 Fehren\">4232 Fehren<\/option><option value=\"4112 Fl\u00fch\">4112 Fl\u00fch<\/option><option value=\"4402 Frenkendorf\">4402 Frenkendorf<\/option><option value=\"4414 F\u00fcllinsdorf\">4414 F\u00fcllinsdorf<\/option><option value=\"4460 Gelterkinden\">4460 Gelterkinden<\/option><option value=\"4145 Gempen\">4145 Gempen<\/option><option value=\"4304 Giebenach\">4304 Giebenach<\/option><option value=\"4203 Grellingen\">4203 Grellingen<\/option><option value=\"4247 Grindel\">4247 Grindel<\/option><option value=\"4445 H\u00e4felfingen\">4445 H\u00e4felfingen<\/option><option value=\"4316 Hellikon\">4316 Hellikon<\/option><option value=\"4465 Hemmiken\">4465 Hemmiken<\/option><option value=\"4423 Hersberg\">4423 Hersberg<\/option><option value=\"4204 Himmelried\">4204 Himmelried<\/option><option value=\"4146 Hochwald\">4146 Hochwald<\/option><option value=\"4114 Hofstetten\">4114 Hofstetten<\/option><option value=\"4434 H\u00f6lstein\">4434 H\u00f6lstein<\/option><option value=\"4452 Itingen\">4452 Itingen<\/option><option value=\"4303 Kaiseraugst\">4303 Kaiseraugst<\/option><option value=\"4447 K\u00e4nerkinden\">4447 K\u00e4nerkinden<\/option><option value=\"4496 Kilchberg\">4496 Kilchberg<\/option><option value=\"4245 Kleinl\u00fctzel\">4245 Kleinl\u00fctzel<\/option><option value=\"4432 Lampenberg\">4432 Lampenberg<\/option><option value=\"4438 Langenbruck\">4438 Langenbruck<\/option><option value=\"4448 L\u00e4ufelfingen\">4448 L\u00e4ufelfingen<\/option><option value=\"4242 Laufen\">4242 Laufen<\/option><option value=\"4415 Lausen\">4415 Lausen<\/option><option value=\"4426 Lauwil\">4426 Lauwil<\/option><option value=\"4436 Liedertswil\">4436 Liedertswil<\/option><option value=\"4254 Liesberg\">4254 Liesberg<\/option><option value=\"4410 Liestal\">4410 Liestal<\/option><option value=\"4419 Lupsingen\">4419 Lupsingen<\/option><option value=\"4312 Magden\">4312 Magden<\/option><option value=\"4464 Maisprach\">4464 Maisprach<\/option><option value=\"4115 Mariastein\">4115 Mariastein<\/option><option value=\"4233 Meltingen\">4233 Meltingen<\/option><option value=\"4115 Metzerlen\">4115 Metzerlen<\/option><option value=\"4313 M\u00f6hlin\">4313 M\u00f6hlin<\/option><option value=\"4322 Mumpf\">4322 Mumpf<\/option><option value=\"4142 M\u00fcnchenstein\">4142 M\u00fcnchenstein<\/option><option value=\"4132 Muttenz\">4132 Muttenz<\/option><option value=\"4224 Nenzlingen\">4224 Nenzlingen<\/option><option value=\"4435 Niederdorf\">4435 Niederdorf<\/option><option value=\"4412 Nuglar\">4412 Nuglar<\/option><option value=\"4208 Nunningen\">4208 Nunningen<\/option><option value=\"4453 Nusshof\">4453 Nusshof<\/option><option value=\"4436 Oberdorf\">4436 Oberdorf<\/option><option value=\"4324 Obermumpf\">4324 Obermumpf<\/option><option value=\"4104 Oberwil\">4104 Oberwil<\/option><option value=\"4305 Olsberg\">4305 Olsberg<\/option><option value=\"4494 Oltingen\">4494 Oltingen<\/option><option value=\"4466 Ormalingen\">4466 Ormalingen<\/option><option value=\"4148 Pfeffingen\">4148 Pfeffingen<\/option><option value=\"4133 Pratteln\">4133 Pratteln<\/option><option value=\"4433 Ramlinsburg\">4433 Ramlinsburg<\/option><option value=\"4418 Reigoldswil\">4418 Reigoldswil<\/option><option value=\"4153 Reinach\">4153 Reinach<\/option><option value=\"4310 Rheinfelden\">4310 Rheinfelden<\/option><option value=\"4462 Rickenbach\">4462 Rickenbach<\/option><option value=\"4125 Riehen\">4125 Riehen<\/option><option value=\"4118 Rodersdorf\">4118 Rodersdorf<\/option><option value=\"2814 Roggenburg\">2814 Roggenburg<\/option><option value=\"4244 R\u00f6schenz\">4244 R\u00f6schenz<\/option><option value=\"4467 Rothenfluh\">4467 Rothenfluh<\/option><option value=\"4444 R\u00fcmlingen\">4444 R\u00fcmlingen<\/option><option value=\"4497 R\u00fcnenberg\">4497 R\u00fcnenberg<\/option><option value=\"4124 Sch\u00f6nenbuch\">4124 Sch\u00f6nenbuch<\/option><option value=\"4325 Schupfart\">4325 Schupfart<\/option><option value=\"4206 Seewen\">4206 Seewen<\/option><option value=\"4411 Seltisberg\">4411 Seltisberg<\/option><option value=\"4450 Sissach\">4450 Sissach<\/option><option value=\"4332 Stein\">4332 Stein<\/option><option value=\"4421 St.Panteleon\">4421 St.Panteleon<\/option><option value=\"4492 Tecknau\">4492 Tecknau<\/option><option value=\"4456 Tenniken\">4456 Tenniken<\/option><option value=\"4106 Therwil\">4106 Therwil<\/option><option value=\"4441 Th\u00fcrnen\">4441 Th\u00fcrnen<\/option><option value=\"4425 Titterten\">4425 Titterten<\/option><option value=\"4246 Wahlen\">4246 Wahlen<\/option><option value=\"4437 Waldenburg\">4437 Waldenburg<\/option><option value=\"4323 Wallbach\">4323 Wallbach<\/option><option value=\"4317 Wegenstetten\">4317 Wegenstetten<\/option><option value=\"4493 Wenslingen\">4493 Wenslingen<\/option><option value=\"4451 Wintersingen\">4451 Wintersingen<\/option><option value=\"4108 Witterswil\">4108 Witterswil<\/option><option value=\"4443 Wittinsburg\">4443 Wittinsburg<\/option><option value=\"4495 Zeglingen\">4495 Zeglingen<\/option><option value=\"4314 Zeiningen\">4314 Zeiningen<\/option><option value=\"4417 Ziefen\">4417 Ziefen<\/option><option value=\"4234 Zullwil\">4234 Zullwil<\/option><option value=\"4455 Zunzgen\">4455 Zunzgen<\/option><option value=\"4315 Zuzgen\">4315 Zuzgen<\/option><option value=\"4222 Zwingen\">4222 Zwingen<\/option><option value=\"9999 Musterstadt\">9999 Musterstadt<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-select quform-element-3_145 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_145\"><label class=\"quform-label-text\" for=\"quform_3_145_0da508\">Verst\u00e4ndigungssprache (falls bekannt)<\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-3_145\"><div class=\"quform-input quform-input-select quform-input-3_145 quform-cf\"><select id=\"quform_3_145_0da508\" name=\"quform_3_145\" class=\"quform-field quform-field-select quform-field-3_145\"><option value=\"\" selected=\"selected\">Bitte w\u00e4hlen<\/option><option value=\"Deutsch\">Deutsch<\/option><option value=\"Englisch\">Englisch<\/option><option value=\"Franz\u00f6sisch\">Franz\u00f6sisch<\/option><option value=\"Italienisch\">Italienisch<\/option><option value=\"Andere\">Andere<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_17 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_17\"><label class=\"quform-label-text\" for=\"quform_3_17_0da508\">Verst\u00e4ndigungssprache<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_17\"><div class=\"quform-input quform-input-text quform-input-3_17 quform-cf\"><input type=\"text\" id=\"quform_3_17_0da508\" name=\"quform_3_17\" class=\"quform-field quform-field-text quform-field-3_17\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-html quform-element-3_168 quform-cf\"><div class=\"quform-spacer\"><h3>Personalien Vater<\/h3><\/div><\/div><div class=\"quform-element quform-element-row quform-element-row-3_169 quform-2-columns quform-element-row-size-fixed quform-responsive-columns-phone-landscape\"><div class=\"quform-element quform-element-column quform-element-3_170\"><div class=\"quform-element quform-element-text quform-element-3_171 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_171\"><label class=\"quform-label-text\" for=\"quform_3_171_0da508\">Vorname Vater<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_171\"><div class=\"quform-input quform-input-text quform-input-3_171 quform-cf\"><input type=\"text\" id=\"quform_3_171_0da508\" name=\"quform_3_171\" class=\"quform-field quform-field-text quform-field-3_171\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_172 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_172\"><label class=\"quform-label-text\" for=\"quform_3_172_0da508\">Name Vater<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_172\"><div class=\"quform-input quform-input-text quform-input-3_172 quform-cf\"><input type=\"text\" id=\"quform_3_172_0da508\" name=\"quform_3_172\" class=\"quform-field quform-field-text quform-field-3_172\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_173 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_173\"><label class=\"quform-label-text\" for=\"quform_3_173_0da508\">Telefon<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_173\"><div class=\"quform-input quform-input-text quform-input-3_173 quform-cf\"><input type=\"text\" id=\"quform_3_173_0da508\" name=\"quform_3_173\" class=\"quform-field quform-field-text quform-field-3_173\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-email quform-element-3_174 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_174\"><label class=\"quform-label-text\" for=\"quform_3_174_0da508\">Email<\/label><\/div><div class=\"quform-inner quform-inner-email quform-inner-3_174\"><div class=\"quform-input quform-input-email quform-input-3_174 quform-cf\"><input type=\"email\" id=\"quform_3_174_0da508\" name=\"quform_3_174\" class=\"quform-field quform-field-email quform-field-3_174\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-column quform-element-3_175\"><div class=\"quform-element quform-element-text quform-element-3_176 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_176\"><label class=\"quform-label-text\" for=\"quform_3_176_0da508\">Strasse und Nr.<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_176\"><div class=\"quform-input quform-input-text quform-input-3_176 quform-cf\"><input type=\"text\" id=\"quform_3_176_0da508\" name=\"quform_3_176\" class=\"quform-field quform-field-text quform-field-3_176\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-select quform-element-3_177 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_177\"><label class=\"quform-label-text\" for=\"quform_3_177_0da508\">PLZ + Ort<\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-3_177\"><div class=\"quform-input quform-input-select quform-input-3_177 quform-cf\"><select id=\"quform_3_177_0da508\" name=\"quform_3_177\" class=\"quform-field quform-field-select quform-field-3_177\"><option value=\"\" selected=\"selected\">Bitte ausw\u00e4hlen<\/option><option value=\"4147 Aesch\">4147 Aesch<\/option><option value=\"4123 Allschwil\">4123 Allschwil<\/option><option value=\"4469 Anwil\">4469 Anwil<\/option><option value=\"4424 Arboldswil\">4424 Arboldswil<\/option><option value=\"4422 Arisdorf\">4422 Arisdorf<\/option><option value=\"4144 Arlesheim\">4144 Arlesheim<\/option><option value=\"4302 Augst\">4302 Augst<\/option><option value=\"4252 B\u00e4rschwil\">4252 B\u00e4rschwil<\/option><option value=\"4001 Basel\">4001 Basel<\/option><option value=\"4051 Basel\">4051 Basel<\/option><option value=\"4052 Basel\">4052 Basel<\/option><option value=\"4053 Basel\">4053 Basel<\/option><option value=\"4054 Basel\">4054 Basel<\/option><option value=\"4055 Basel\">4055 Basel<\/option><option value=\"4056 Basel\">4056 Basel<\/option><option value=\"4057 Basel\">4057 Basel<\/option><option value=\"4058 Basel\">4058 Basel<\/option><option value=\"4059 Basel\">4059 Basel<\/option><option value=\"4112 B\u00e4ttwil\">4112 B\u00e4ttwil<\/option><option value=\"4229 Beinwil\">4229 Beinwil<\/option><option value=\"4431 Bennwil\">4431 Bennwil<\/option><option value=\"4126 Bettingen\">4126 Bettingen<\/option><option value=\"4105 Biel-Benken\">4105 Biel-Benken<\/option><option value=\"4102 Binningen\">4102 Binningen<\/option><option value=\"4127 Birsfelden\">4127 Birsfelden<\/option><option value=\"4223 Blauen\">4223 Blauen<\/option><option value=\"4461 B\u00f6ckten\">4461 B\u00f6ckten<\/option><option value=\"4103 Bottmingen\">4103 Bottmingen<\/option><option value=\"4226 Breitenbach\">4226 Breitenbach<\/option><option value=\"4207 Bretzwil\">4207 Bretzwil<\/option><option value=\"4225 Brislach\">4225 Brislach<\/option><option value=\"4416 Bubendorf\">4416 Bubendorf<\/option><option value=\"4446 Buckten\">4446 Buckten<\/option><option value=\"4413 B\u00fcren\">4413 B\u00fcren<\/option><option value=\"4117 Burg\">4117 Burg<\/option><option value=\"4227 B\u00fcsserach\">4227 B\u00fcsserach<\/option><option value=\"4463 Buus\">4463 Buus<\/option><option value=\"4457 Diegten\">4457 Diegten<\/option><option value=\"4442 Diepflingen\">4442 Diepflingen<\/option><option value=\"4243 Dittingen\">4243 Dittingen<\/option><option value=\"4143 Dornach\">4143 Dornach<\/option><option value=\"4202 Duggingen\">4202 Duggingen<\/option><option value=\"4458 Eptingen\">4458 Eptingen<\/option><option value=\"4228 Erschwil\">4228 Erschwil<\/option><option value=\"4107 Ettingen\">4107 Ettingen<\/option><option value=\"4232 Fehren\">4232 Fehren<\/option><option value=\"4112 Fl\u00fch\">4112 Fl\u00fch<\/option><option value=\"4402 Frenkendorf\">4402 Frenkendorf<\/option><option value=\"4414 F\u00fcllinsdorf\">4414 F\u00fcllinsdorf<\/option><option value=\"4460 Gelterkinden\">4460 Gelterkinden<\/option><option value=\"4145 Gempen\">4145 Gempen<\/option><option value=\"4304 Giebenach\">4304 Giebenach<\/option><option value=\"4203 Grellingen\">4203 Grellingen<\/option><option value=\"4247 Grindel\">4247 Grindel<\/option><option value=\"4445 H\u00e4felfingen\">4445 H\u00e4felfingen<\/option><option value=\"4316 Hellikon\">4316 Hellikon<\/option><option value=\"4465 Hemmiken\">4465 Hemmiken<\/option><option value=\"4423 Hersberg\">4423 Hersberg<\/option><option value=\"4204 Himmelried\">4204 Himmelried<\/option><option value=\"4146 Hochwald\">4146 Hochwald<\/option><option value=\"4114 Hofstetten\">4114 Hofstetten<\/option><option value=\"4434 H\u00f6lstein\">4434 H\u00f6lstein<\/option><option value=\"4452 Itingen\">4452 Itingen<\/option><option value=\"4303 Kaiseraugst\">4303 Kaiseraugst<\/option><option value=\"4447 K\u00e4nerkinden\">4447 K\u00e4nerkinden<\/option><option value=\"4496 Kilchberg\">4496 Kilchberg<\/option><option value=\"4245 Kleinl\u00fctzel\">4245 Kleinl\u00fctzel<\/option><option value=\"4432 Lampenberg\">4432 Lampenberg<\/option><option value=\"4438 Langenbruck\">4438 Langenbruck<\/option><option value=\"4448 L\u00e4ufelfingen\">4448 L\u00e4ufelfingen<\/option><option value=\"4242 Laufen\">4242 Laufen<\/option><option value=\"4415 Lausen\">4415 Lausen<\/option><option value=\"4426 Lauwil\">4426 Lauwil<\/option><option value=\"4436 Liedertswil\">4436 Liedertswil<\/option><option value=\"4254 Liesberg\">4254 Liesberg<\/option><option value=\"4410 Liestal\">4410 Liestal<\/option><option value=\"4419 Lupsingen\">4419 Lupsingen<\/option><option value=\"4312 Magden\">4312 Magden<\/option><option value=\"4464 Maisprach\">4464 Maisprach<\/option><option value=\"4115 Mariastein\">4115 Mariastein<\/option><option value=\"4233 Meltingen\">4233 Meltingen<\/option><option value=\"4115 Metzerlen\">4115 Metzerlen<\/option><option value=\"4313 M\u00f6hlin\">4313 M\u00f6hlin<\/option><option value=\"4322 Mumpf\">4322 Mumpf<\/option><option value=\"4142 M\u00fcnchenstein\">4142 M\u00fcnchenstein<\/option><option value=\"4132 Muttenz\">4132 Muttenz<\/option><option value=\"4224 Nenzlingen\">4224 Nenzlingen<\/option><option value=\"4435 Niederdorf\">4435 Niederdorf<\/option><option value=\"4412 Nuglar\">4412 Nuglar<\/option><option value=\"4208 Nunningen\">4208 Nunningen<\/option><option value=\"4453 Nusshof\">4453 Nusshof<\/option><option value=\"4436 Oberdorf\">4436 Oberdorf<\/option><option value=\"4324 Obermumpf\">4324 Obermumpf<\/option><option value=\"4104 Oberwil\">4104 Oberwil<\/option><option value=\"4305 Olsberg\">4305 Olsberg<\/option><option value=\"4494 Oltingen\">4494 Oltingen<\/option><option value=\"4466 Ormalingen\">4466 Ormalingen<\/option><option value=\"4148 Pfeffingen\">4148 Pfeffingen<\/option><option value=\"4133 Pratteln\">4133 Pratteln<\/option><option value=\"4433 Ramlinsburg\">4433 Ramlinsburg<\/option><option value=\"4418 Reigoldswil\">4418 Reigoldswil<\/option><option value=\"4153 Reinach\">4153 Reinach<\/option><option value=\"4310 Rheinfelden\">4310 Rheinfelden<\/option><option value=\"4462 Rickenbach\">4462 Rickenbach<\/option><option value=\"4125 Riehen\">4125 Riehen<\/option><option value=\"4118 Rodersdorf\">4118 Rodersdorf<\/option><option value=\"2814 Roggenburg\">2814 Roggenburg<\/option><option value=\"4244 R\u00f6schenz\">4244 R\u00f6schenz<\/option><option value=\"4467 Rothenfluh\">4467 Rothenfluh<\/option><option value=\"4444 R\u00fcmlingen\">4444 R\u00fcmlingen<\/option><option value=\"4497 R\u00fcnenberg\">4497 R\u00fcnenberg<\/option><option value=\"4124 Sch\u00f6nenbuch\">4124 Sch\u00f6nenbuch<\/option><option value=\"4325 Schupfart\">4325 Schupfart<\/option><option value=\"4206 Seewen\">4206 Seewen<\/option><option value=\"4411 Seltisberg\">4411 Seltisberg<\/option><option value=\"4450 Sissach\">4450 Sissach<\/option><option value=\"4332 Stein\">4332 Stein<\/option><option value=\"4421 St.Panteleon\">4421 St.Panteleon<\/option><option value=\"4492 Tecknau\">4492 Tecknau<\/option><option value=\"4456 Tenniken\">4456 Tenniken<\/option><option value=\"4106 Therwil\">4106 Therwil<\/option><option value=\"4441 Th\u00fcrnen\">4441 Th\u00fcrnen<\/option><option value=\"4425 Titterten\">4425 Titterten<\/option><option value=\"4246 Wahlen\">4246 Wahlen<\/option><option value=\"4437 Waldenburg\">4437 Waldenburg<\/option><option value=\"4323 Wallbach\">4323 Wallbach<\/option><option value=\"4317 Wegenstetten\">4317 Wegenstetten<\/option><option value=\"4493 Wenslingen\">4493 Wenslingen<\/option><option value=\"4451 Wintersingen\">4451 Wintersingen<\/option><option value=\"4108 Witterswil\">4108 Witterswil<\/option><option value=\"4443 Wittinsburg\">4443 Wittinsburg<\/option><option value=\"4495 Zeglingen\">4495 Zeglingen<\/option><option value=\"4314 Zeiningen\">4314 Zeiningen<\/option><option value=\"4417 Ziefen\">4417 Ziefen<\/option><option value=\"4234 Zullwil\">4234 Zullwil<\/option><option value=\"4455 Zunzgen\">4455 Zunzgen<\/option><option value=\"4315 Zuzgen\">4315 Zuzgen<\/option><option value=\"4222 Zwingen\">4222 Zwingen<\/option><option value=\"9999 Musterstadt\">9999 Musterstadt<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-select quform-element-3_178 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_178\"><label class=\"quform-label-text\" for=\"quform_3_178_0da508\">Verst\u00e4ndigungssprache (falls bekannt)<\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-3_178\"><div class=\"quform-input quform-input-select quform-input-3_178 quform-cf\"><select id=\"quform_3_178_0da508\" name=\"quform_3_178\" class=\"quform-field quform-field-select quform-field-3_178\"><option value=\"\" selected=\"selected\">Bitte w\u00e4hlen<\/option><option value=\"Deutsch\">Deutsch<\/option><option value=\"Englisch\">Englisch<\/option><option value=\"Franz\u00f6sisch\">Franz\u00f6sisch<\/option><option value=\"Italienisch\">Italienisch<\/option><option value=\"Andere\">Andere<\/option><\/select><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_179 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_179\"><label class=\"quform-label-text\" for=\"quform_3_179_0da508\">Verst\u00e4ndigungssprache<\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_179\"><div class=\"quform-input quform-input-text quform-input-3_179 quform-cf\"><input type=\"text\" id=\"quform_3_179_0da508\" name=\"quform_3_179\" class=\"quform-field quform-field-text quform-field-3_179\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-html quform-element-3_58 quform-cf\"><div class=\"quform-spacer\"><h3>Personalien Kind<\/h3><\/div><\/div><div class=\"quform-element quform-element-row quform-element-row-3_71 quform-2-columns quform-element-row-size-fixed quform-responsive-columns-phone-landscape\"><div class=\"quform-element quform-element-column quform-element-3_72\"><div class=\"quform-element quform-element-text quform-element-3_73 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_73\"><label class=\"quform-label-text\" for=\"quform_3_73_0da508\">Name Kind <span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_73\"><div class=\"quform-input quform-input-text quform-input-3_73 quform-cf\"><input type=\"text\" id=\"quform_3_73_0da508\" name=\"quform_3_73\" class=\"quform-field quform-field-text quform-field-3_73\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_79 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_79\"><label class=\"quform-label-text\" for=\"quform_3_79_0da508\">Vorname Kind<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_79\"><div class=\"quform-input quform-input-text quform-input-3_79 quform-cf\"><input type=\"text\" id=\"quform_3_79_0da508\" name=\"quform_3_79\" class=\"quform-field quform-field-text quform-field-3_79\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-date quform-element-3_80 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_80\"><label class=\"quform-label-text\" for=\"quform_3_80_0da508\">Geburtsdatum<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-date quform-inner-3_80\"><div class=\"quform-input quform-input-date quform-input-3_80 quform-cf quform-has-field-icon-right\"><input type=\"text\" id=\"quform_3_80_0da508\" name=\"quform_3_80\" class=\"quform-field quform-field-date quform-field-3_80\" placeholder=\"YYYY-MM-DD\" data-options=\"{&quot;format&quot;:&quot;&quot;,&quot;min&quot;:&quot;&quot;,&quot;max&quot;:&quot;&quot;,&quot;start&quot;:&quot;month&quot;,&quot;depth&quot;:&quot;month&quot;,&quot;showFooter&quot;:false,&quot;locale&quot;:&quot;de-CH&quot;,&quot;placeholder&quot;:&quot;&quot;,&quot;autoOpen&quot;:true,&quot;identifier&quot;:&quot;3_80&quot;}\" \/><span class=\"quform-field-icon quform-field-icon-right\"><i class=\"qicon-calendar\"><\/i><\/span><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-checkbox quform-element-3_23 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_23\"><label class=\"quform-label-text\" id=\"quform_3_23_0da508_label\">Geschlecht<\/label><\/div><div class=\"quform-inner quform-inner-checkbox quform-inner-3_23\"><div class=\"quform-input quform-input-checkbox quform-input-3_23 quform-cf\"><div class=\"quform-options quform-cf quform-options-block quform-options-simple\" role=\"group\" aria-labelledby=\"quform_3_23_0da508_label\"><div class=\"quform-option\"><input type=\"checkbox\" name=\"quform_3_23[]\" id=\"quform_3_23_0da508_1\" class=\"quform-field quform-field-checkbox quform-field-3_23 quform-field-3_23_1\" value=\"M\" \/><label for=\"quform_3_23_0da508_1\" class=\"quform-option-label quform-option-label-3_23_1\"><span class=\"quform-option-text\">M<\/span><\/label><\/div><div class=\"quform-option\"><input type=\"checkbox\" name=\"quform_3_23[]\" id=\"quform_3_23_0da508_2\" class=\"quform-field quform-field-checkbox quform-field-3_23 quform-field-3_23_2\" value=\"F\" \/><label for=\"quform_3_23_0da508_2\" class=\"quform-option-label quform-option-label-3_23_2\"><span class=\"quform-option-text\">F<\/span><\/label><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-column quform-element-3_78\"><div class=\"quform-element quform-element-textarea quform-element-3_180 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_180\"><label class=\"quform-label-text\" for=\"quform_3_180_0da508\">Geschwister<\/label><\/div><div class=\"quform-inner quform-inner-textarea quform-inner-3_180\"><div class=\"quform-input quform-input-textarea quform-input-3_180 quform-cf\"><textarea id=\"quform_3_180_0da508\" name=\"quform_3_180\" class=\"quform-field quform-field-textarea quform-field-3_180\"><\/textarea><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-textarea quform-element-3_83 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_83\"><label class=\"quform-label-text\" for=\"quform_3_83_0da508\">Bemerkungen<\/label><\/div><div class=\"quform-inner quform-inner-textarea quform-inner-3_83\"><div class=\"quform-input quform-input-textarea quform-input-3_83 quform-cf\"><textarea id=\"quform_3_83_0da508\" name=\"quform_3_83\" class=\"quform-field quform-field-textarea quform-field-3_83\"><\/textarea><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-textarea quform-element-3_607620 quform-sr-only quform-cf\" style=\"clip: rect(1px, 1px, 1px, 1px); clip-path: inset(50%); position: absolute !important; height: 1px; width: 1px; overflow: hidden;\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_607620\"><label class=\"quform-label-text\" for=\"quform_3_607620_0da508\">Email Address<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-3_607620\"><textarea id=\"quform_3_607620_0da508\" name=\"quform_3_607620\" class=\"quform-field quform-field-textarea quform-field-3_607620\" tabindex=\"-1\" autocomplete=\"new-password\"><\/textarea><\/div><\/div><\/div><div class=\"quform-element quform-element-html quform-element-3_128 quform-cf\"><div class=\"quform-spacer\"><h3>Absender<\/h3><\/div><\/div><div class=\"quform-element quform-element-row quform-element-row-3_129 quform-1-columns quform-element-row-size-fixed quform-responsive-columns-phone-landscape\"><div class=\"quform-element quform-element-column quform-element-3_130\"><div class=\"quform-element quform-element-text quform-element-3_134 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_134\"><label class=\"quform-label-text\" for=\"quform_3_134_0da508\">Vorname + Name<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_134\"><div class=\"quform-input quform-input-text quform-input-3_134 quform-cf\"><input type=\"text\" id=\"quform_3_134_0da508\" name=\"quform_3_134\" class=\"quform-field quform-field-text quform-field-3_134\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-3_132 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_132\"><label class=\"quform-label-text\" for=\"quform_3_132_0da508\">Telefon<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-3_132\"><div class=\"quform-input quform-input-text quform-input-3_132 quform-cf\"><input type=\"text\" id=\"quform_3_132_0da508\" name=\"quform_3_132\" class=\"quform-field quform-field-text quform-field-3_132\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-email quform-element-3_135 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-3_135\"><label class=\"quform-label-text\" for=\"quform_3_135_0da508\">Email<\/label><\/div><div class=\"quform-inner quform-inner-email quform-inner-3_135\"><div class=\"quform-input quform-input-email quform-input-3_135 quform-cf\"><input type=\"email\" id=\"quform_3_135_0da508\" name=\"quform_3_135\" class=\"quform-field quform-field-email quform-field-3_135\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-submit quform-element-3_2 quform-cf quform-button-style-theme\"><div class=\"quform-button-submit quform-button-submit-default quform-button-submit-3_2 quform-button-icon-right\"><button name=\"quform_submit\" type=\"submit\" class=\"quform-submit\" value=\"submit\"><span class=\"quform-button-text quform-button-submit-text\">Senden<\/span><span class=\"quform-button-icon quform-button-submit-icon\"><i class=\"qicon-send\"><\/i><\/span><\/button><\/div><div class=\"quform-loading quform-loading-position-left quform-loading-type-spinner-1\"><div class=\"quform-loading-inner\"><div class=\"quform-loading-spinner\"><div 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