[paytium name="Heartfulness betalen termijnen" description="Heartfulness termijnen" amount="175,-" button_label="Betalen"] [paytium_field type="firstname" label="Voornaam" required="true" /] [paytium_field type="lastname" label="Achternaam" required="true" /] [paytium_field type="email" label="Email" required="true" newsletter="activecampaign" newsletter_hide_checkbox="true" newsletter_after="true" newsletter_list="24" /] [paytium_field type="text" label="Adres" required="true" /] [paytium_field type="text" label="Postcode" required="true" /] [paytium_field type="text" label="Plaatsnaam" required="true" /] [paytium_field type="text" label="Land" required="true" /] [paytium_field type="text" label="Mobiel telefoonnummer" required="true" /] [paytium_field type="terms" label="Ik ga akkoord met de Algemene Voorwaarden" link="https://reneeoverboom.nl/wp-content/uploads/2019/09/ALGEMENE-VOORWAARDEN-RENEE-OVERBOOM-COACHING.pdf" required="true"/] [paytium_total /] [/paytium]