[paytium name="Formulier naam" description="Abonnement voor cursus prestatieverbetering" button_label="Aanmelden"] [paytium_subscription interval="1 day" times="4" first_payment="" /] [paytium_field type="name" label="Volledige naam" /] [paytium_field type="email" label="Email" required="true" /] [paytium_field type="label" label="Subscription €579" amount="579" /] [paytium_field type="text" label="Straatnaam" required="true" /] [paytium_field type="text" label="Huisnummer" required="true" /] [paytium_field type="text" label="Postcode" required="true" /] [paytium_field type="text" label="Woonplaats" required="true" /] [paytium_field type="label" label="Product Prestatieverbetering VIP 12 maand / months for €579" amount="579" /] [paytium_field type="terms" label="I accept the terms & conditions" link="https://paselir-online-academy.com/algemene-voorwaarden" required="true" /] [paytium_total /] [/paytium]