{"id":45,"date":"2020-03-26T11:30:40","date_gmt":"2020-03-26T02:30:40","guid":{"rendered":"https:\/\/cafic.tokyo\/reserve\/?page_id=45"},"modified":"2025-02-21T14:05:35","modified_gmt":"2025-02-21T05:05:35","slug":"register","status":"publish","type":"page","link":"https:\/\/cafic.tokyo\/reserve\/register\/","title":{"rendered":"\u65b0\u898f\u4f1a\u54e1\u767b\u9332"},"content":{"rendered":"\n<p>\u300c<span style=\"color: #ff0000\" class=\"text-color\">*<\/span>\u300d\u304c\u4ed8\u3044\u305f\u9805\u76ee\u306f\u5fc5\u9808\u5165\u529b\u3067\u3059<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u751f\u5e74\u6708\u65e5\u306e\u5165\u529b\u65b9\u6cd5\u306b\u3064\u3044\u3066<\/h3>\n\n\n\n<div class=\"wp-block-luxe-blocks-accordion\" style=\"margin-top:10px;margin-bottom:30px\"><input id=\"e02396d9deeb0fc2af3567c113f4\" class=\"acb\" type=\"checkbox\" style=\"display:none\"\/><label class=\"acl\" for=\"e02396d9deeb0fc2af3567c113f4\" style=\"color:#000000;background-color:#f5f5f5;border:1px solid #f5f5f5;display:flex;margin:0\"><div class=\"act\" style=\"padding:5px 15px;flex:1 0\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"18\" height=\"18\" viewBox=\"0 2 24 28\"><path d=\"M5.672 24l1.422-1.422-3.672-3.672-1.422 1.422v1.672h2v2h1.672zM13.844 9.5c0-0.203-0.141-0.344-0.344-0.344-0.094 0-0.187 0.031-0.266 0.109l-8.469 8.469c-0.078 0.078-0.109 0.172-0.109 0.266 0 0.203 0.141 0.344 0.344 0.344 0.094 0 0.187-0.031 0.266-0.109l8.469-8.469c0.078-0.078 0.109-0.172 0.109-0.266zM13 6.5l6.5 6.5-13 13h-6.5v-6.5zM23.672 8c0 0.531-0.219 1.047-0.578 1.406l-2.594 2.594-6.5-6.5 2.594-2.578c0.359-0.375 0.875-0.594 1.406-0.594s1.047 0.219 1.422 0.594l3.672 3.656c0.359 0.375 0.578 0.891 0.578 1.422z\" fill=\"#000000\"><\/path><\/svg><span>\u30b9\u30de\u30fc\u30c8\u30d5\u30a9\u30f3\u306e\u5834\u5408<\/span><\/div><div class=\"aci\" style=\"margin:5px 0;padding:0 15px;border-left:1px solid #fff\"><\/div><\/label><div class=\"acc\" style=\"border:1px dotted #808080\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"774\" src=\"https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_mobile.jpg\" alt=\"\" class=\"wp-image-174\" srcset=\"https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_mobile.jpg 600w, https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_mobile-233x300.jpg 233w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/figure>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-luxe-blocks-accordion\" style=\"margin-top:10px;margin-bottom:30px\"><input id=\"c0f4ea343540e806b17d543cecd1\" class=\"acb\" type=\"checkbox\" style=\"display:none\"\/><label class=\"acl\" for=\"c0f4ea343540e806b17d543cecd1\" style=\"color:#000000;background-color:#f5f5f5;border:1px solid #f5f5f5;display:flex;margin:0\"><div class=\"act\" style=\"padding:5px 15px;flex:1 0\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"18\" height=\"18\" viewBox=\"0 2 24 28\"><path d=\"M5.672 24l1.422-1.422-3.672-3.672-1.422 1.422v1.672h2v2h1.672zM13.844 9.5c0-0.203-0.141-0.344-0.344-0.344-0.094 0-0.187 0.031-0.266 0.109l-8.469 8.469c-0.078 0.078-0.109 0.172-0.109 0.266 0 0.203 0.141 0.344 0.344 0.344 0.094 0 0.187-0.031 0.266-0.109l8.469-8.469c0.078-0.078 0.109-0.172 0.109-0.266zM13 6.5l6.5 6.5-13 13h-6.5v-6.5zM23.672 8c0 0.531-0.219 1.047-0.578 1.406l-2.594 2.594-6.5-6.5 2.594-2.578c0.359-0.375 0.875-0.594 1.406-0.594s1.047 0.219 1.422 0.594l3.672 3.656c0.359 0.375 0.578 0.891 0.578 1.422z\" fill=\"#000000\"><\/path><\/svg><span>\u30d1\u30bd\u30b3\u30f3\u306e\u5834\u5408<\/span><\/div><div class=\"aci\" style=\"margin:5px 0;padding:0 15px;border-left:1px solid #fff\"><\/div><\/label><div class=\"acc\" style=\"border:1px dotted #006edc\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"1000\" src=\"https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_pc.jpg\" alt=\"\" class=\"wp-image-175\" srcset=\"https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_pc.jpg 600w, https:\/\/cafic.tokyo\/reserve\/wp-content\/uploads\/2024\/10\/date_input_pc-180x300.jpg 180w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/figure>\n<\/div><\/div>\n\n\n\n<p>\u300cCAPTCHA \u304c\u6b63\u3057\u304f\u3042\u308a\u307e\u305b\u3093\u3002\u300d\u3068\u3044\u3046\u30a8\u30e9\u30fc\u306b\u306a\u3063\u305f\u5834\u5408\u3001\u30d1\u30b9\u30ef\u30fc\u30c9\u306e\u307f\u5165\u308c\u76f4\u3057\u3066\u3082\u3046\u4e00\u5ea6\u300c\u767b\u9332\u300d\u30dc\u30bf\u30f3\u3092\u62bc\u3057\u3066\u304f\u3060\u3055\u3044\u3002<br>\u306a\u304a\u767b\u9332\u51fa\u6765\u306a\u3044\u5834\u5408\u3001\u6050\u308c\u5165\u308a\u307e\u3059\u304c\u300c<a href=\"https:\/\/cafic.tokyo\/contact\/\">\u304a\u554f\u3044\u5408\u308f\u305b<\/a>\u300d\u3088\u308a\u3054\u9023\u7d61\u304f\u3060\u3055\u3044\u3002<\/p>\n\n\n\n<div id=\"wpmem_reg\"><a id=\"register\"><\/a><form name=\"form\" method=\"post\" action=\"https:\/\/cafic.tokyo\/reserve\/register\/\" id=\"wpmem_register_form\" class=\"form\"><input type=\"hidden\" id=\"_wpmem_register_nonce\" name=\"_wpmem_register_nonce\" value=\"bb39ac069f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/reserve\/wp-json\/wp\/v2\/pages\/45\" \/><fieldset><legend>\u65b0\u898f\u30e6\u30fc\u30b6\u30fc\u767b\u9332<\/legend><label for=\"last_name\" class=\"text\">\u59d3<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"last_name\" type=\"text\" id=\"last_name\" value=\"\" class=\"textbox\" required  \/><\/div><label for=\"first_name\" class=\"text\">\u540d<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"first_name\" type=\"text\" id=\"first_name\" value=\"\" class=\"textbox\" required  \/><\/div><label for=\"kana\" class=\"text\">\u3075\u308a\u304c\u306a<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"kana\" type=\"text\" id=\"kana\" value=\"\" class=\"textbox\" placeholder=\"\u7a7a\u767d\u306a\u3057\u3067\" required  \/><\/div><label for=\"sex\" class=\"radio\">\u6027\u5225<span class=\"req\">*<\/span><\/label><div class=\"div_radio\"><input type=\"radio\" name=\"sex\" id=\"sex_1\" value=\"\u5973\" required > <label for=\"sex_1\" id=\"label_sex_1\" class=\"radio\">\u5973<\/label><br \/><input type=\"radio\" name=\"sex\" id=\"sex_2\" value=\"\u7537\" required > <label for=\"sex_2\" id=\"label_sex_2\" class=\"radio\">\u7537<\/label><br \/><\/div><label for=\"birthday\" class=\"date\">\u751f\u5e74\u6708\u65e5<span class=\"req\">*<\/span><\/label><div class=\"div_date\"><input name=\"birthday\" type=\"date\" id=\"birthday\" value=\"\" class=\"textbox\" placeholder=\"1970\/12\/5\" required  \/><\/div><label for=\"billing_postcode\" class=\"text\">\u90f5\u4fbf\u756a\u53f7<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"billing_postcode\" type=\"text\" id=\"billing_postcode\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a0000000\uff08\u30cf\u30a4\u30d5\u30f3\u7121\u3057\uff09\" required  \/><\/div><label for=\"billing_state\" class=\"text\">\u90fd\u9053\u5e9c\u770c<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"billing_state\" type=\"text\" id=\"billing_state\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u6771\u4eac\u90fd\" required  \/><\/div><label for=\"billing_city\" class=\"text\">\u5e02\u533a\u753a\u6751<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"billing_city\" type=\"text\" id=\"billing_city\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u8c4a\u5cf6\u533a\" required  \/><\/div><label for=\"billing_address_1\" class=\"text\">\u4f4f\u62401<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"billing_address_1\" type=\"text\" id=\"billing_address_1\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u6771\u6c60\u888b2-63-1\" required  \/><\/div><label for=\"billing_address_2\" class=\"text\">\u4f4f\u62402<\/label><div class=\"div_text\"><input name=\"billing_address_2\" type=\"text\" id=\"billing_address_2\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u6771\u6c60\u888b\u30d1\u30ec\u30b9505\u53f7\u5ba4\" \/><\/div><label for=\"billing_phone\" class=\"text\">\u9023\u7d61\u5148\u96fb\u8a71\u756a\u53f7<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"billing_phone\" type=\"text\" id=\"billing_phone\" value=\"\" class=\"textbox\" placeholder=\"\u534a\u89d2\u6570\u5b57\u30cf\u30a4\u30d5\u30f3\u7121\u3057\u3067\" required  \/><\/div><label for=\"user_email\" class=\"text\">\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"user_email\" type=\"email\" id=\"user_email\" value=\"\" class=\"textbox\" placeholder=\"\u534a\u89d2\u3067\" required  \/><\/div><label for=\"confirm_email\" class=\"text\">\u30e1\u30fc\u30eb\uff08\u78ba\u8a8d\uff09<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"confirm_email\" type=\"email\" id=\"confirm_email\" value=\"\" class=\"textbox\" required  \/><\/div><label for=\"password\" class=\"text\">\u5e0c\u671b\u30d1\u30b9\u30ef\u30fc\u30c9\uff08\u534a\u89d2\u82f1\u6570\u5b578\u6587\u5b57\u4ee5\u4e0a30\u6587\u5b57\u4ee5\u5185\uff09<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"password\" type=\"password\" id=\"password\" class=\"textbox\" placeholder=\"\u534a\u89d2\u82f1\u6570\u5b57\" required  \/><\/div><label for=\"confirm_password\" class=\"text\">\u5e0c\u671b\u30d1\u30b9\u30ef\u30fc\u30c9\uff08\u78ba\u8a8d\uff09<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"confirm_password\" type=\"password\" id=\"confirm_password\" class=\"textbox\" required  \/><\/div><label for=\"problems\" class=\"textarea\">\u76f8\u8ac7\u3057\u305f\u3044\u3053\u3068<span class=\"req\">*<\/span><\/label><div class=\"div_textarea\"><textarea cols=\"20\" rows=\"5\" name=\"problems\" id=\"problems\" class=\"textarea\" required ><\/textarea><\/div><label for=\"psychiatry\" class=\"radio\">\u7cbe\u795e\u79d1\u30fb\u5fc3\u7642\u5185\u79d1\u306e\u5229\u7528<span class=\"req\">*<\/span><\/label><div class=\"div_radio\"><input type=\"radio\" name=\"psychiatry\" id=\"psychiatry_1\" value=\"\u6709\u308a\" required > <label for=\"psychiatry_1\" id=\"label_psychiatry_1\" class=\"radio\">\u6709\u308a<\/label><br \/><input type=\"radio\" name=\"psychiatry\" id=\"psychiatry_2\" value=\"\u7121\u3057\" required > <label for=\"psychiatry_2\" id=\"label_psychiatry_2\" class=\"radio\">\u7121\u3057<\/label><br \/><\/div><label for=\"doctor\" class=\"radio\">\u4e3b\u6cbb\u533b\u306e\u8a31\u53ef<\/label><div class=\"div_radio\"><input type=\"radio\" name=\"doctor\" id=\"doctor_1\" value=\"\u6709\u308a\" > <label for=\"doctor_1\" id=\"label_doctor_1\" class=\"radio\">\u6709\u308a<\/label><br \/><input type=\"radio\" name=\"doctor\" id=\"doctor_2\" value=\"\u7121\u3057\" > <label for=\"doctor_2\" id=\"label_doctor_2\" class=\"radio\">\u7121\u3057<\/label><br \/><\/div><label for=\"history\" class=\"textarea\">\u65e2\u5f80\u6b74<\/label><div class=\"div_textarea\"><textarea cols=\"20\" rows=\"2\" name=\"history\" id=\"history\" class=\"textarea\" placeholder=\"\u4f8b\uff1a\u81ea\u5f8b\u795e\u7d4c\u5931\u8abf\u75c7\"><\/textarea><\/div><label for=\"route\" class=\"text\">\u5f53\u76f8\u8ac7\u5ba4\u5229\u7528\u306e\u304d\u3063\u304b\u3051\u3001\u7d4c\u8def<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"route\" type=\"text\" id=\"route\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u53cb\u4eba\u306e\u7d39\u4ecb\" required  \/><\/div><label for=\"occupation\" class=\"text\">\u8077\u696d<span class=\"req\">*<\/span><\/label><div class=\"div_text\"><input name=\"occupation\" type=\"text\" id=\"occupation\" value=\"\" class=\"textbox\" placeholder=\"\u4f8b\uff1a\u7121\u8077\" required  \/><\/div><label for=\"week\" class=\"multicheckbox\">\u5e0c\u671b\u66dc\u65e5\uff08\u8907\u6570\u9078\u629e\u53ef\uff09<span class=\"req\">*<\/span><\/label><div class=\"div_multicheckbox\"><input name=\"week[]\" type=\"checkbox\" id=\"week[\u5e0c\u671b\u7121\u3057]\" value=\"\u5e0c\u671b\u7121\u3057\" \/>&nbsp;<label for=\"week[\u5e0c\u671b\u7121\u3057]\" id=\"week[\u5e0c\u671b\u7121\u3057]\" class=\"multicheckbox\">\u5e0c\u671b\u7121\u3057<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u6708]\" value=\"\u6708\" \/>&nbsp;<label for=\"week[\u6708]\" id=\"week[\u6708]\" class=\"multicheckbox\">\u6708<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u6c34]\" value=\"\u6c34\" \/>&nbsp;<label for=\"week[\u6c34]\" id=\"week[\u6c34]\" class=\"multicheckbox\">\u6c34<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u6728]\" value=\"\u6728\" \/>&nbsp;<label for=\"week[\u6728]\" id=\"week[\u6728]\" class=\"multicheckbox\">\u6728<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u91d1]\" value=\"\u91d1\" \/>&nbsp;<label for=\"week[\u91d1]\" id=\"week[\u91d1]\" class=\"multicheckbox\">\u91d1<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u571f]\" value=\"\u571f\" \/>&nbsp;<label for=\"week[\u571f]\" id=\"week[\u571f]\" class=\"multicheckbox\">\u571f<\/label><br \/><input name=\"week[]\" type=\"checkbox\" id=\"week[\u65e5]\" value=\"\u65e5\" \/>&nbsp;<label for=\"week[\u65e5]\" id=\"week[\u65e5]\" class=\"multicheckbox\">\u65e5<\/label><br \/><\/div><label for=\"time\" class=\"multicheckbox\">\u5e0c\u671b\u6642\u9593\u5e2f<span class=\"req\">*<\/span><\/label><div class=\"div_multicheckbox\"><input name=\"time[]\" type=\"checkbox\" id=\"time[\u5e0c\u671b\u7121\u3057]\" value=\"\u5e0c\u671b\u7121\u3057\" \/>&nbsp;<label for=\"time[\u5e0c\u671b\u7121\u3057]\" id=\"time[\u5e0c\u671b\u7121\u3057]\" class=\"multicheckbox\">\u5e0c\u671b\u7121\u3057<\/label><br \/><input name=\"time[]\" type=\"checkbox\" id=\"time[\u5348\u524d\u4e2d]\" value=\"\u5348\u524d\u4e2d\" \/>&nbsp;<label for=\"time[\u5348\u524d\u4e2d]\" id=\"time[\u5348\u524d\u4e2d]\" class=\"multicheckbox\">\u5348\u524d\u4e2d<\/label><br \/><input name=\"time[]\" type=\"checkbox\" id=\"time[\u5348\u5f8c]\" value=\"\u5348\u5f8c\" \/>&nbsp;<label for=\"time[\u5348\u5f8c]\" id=\"time[\u5348\u5f8c]\" class=\"multicheckbox\">\u5348\u5f8c<\/label><br \/><\/div><label for=\"counseling\" class=\"multicheckbox\">\u3054\u5e0c\u671b\u306e\u76f8\u8ac7\u5f62\u614b\uff08\u8907\u6570\u9078\u629e\u53ef\uff09<span class=\"req\">*<\/span><\/label><div class=\"div_multicheckbox\"><input name=\"counseling[]\" type=\"checkbox\" id=\"counseling[\u5bfe\u9762\u76f8\u8ac7]\" value=\"\u5bfe\u9762\u76f8\u8ac7\" \/>&nbsp;<label for=\"counseling[\u5bfe\u9762\u76f8\u8ac7]\" id=\"counseling[\u5bfe\u9762\u76f8\u8ac7]\" class=\"multicheckbox\">\u5bfe\u9762\u76f8\u8ac7<\/label><br \/><input name=\"counseling[]\" type=\"checkbox\" id=\"counseling[ZOOM\u76f8\u8ac7]\" value=\"ZOOM\u76f8\u8ac7\" \/>&nbsp;<label for=\"counseling[ZOOM\u76f8\u8ac7]\" id=\"counseling[ZOOM\u76f8\u8ac7]\" class=\"multicheckbox\">ZOOM\u76f8\u8ac7<\/label><br \/><\/div><label for=\"question\" class=\"textarea\">\u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0\u306b\u95a2\u3059\u308b\u3054\u8981\u671b\u30fb\u3054\u8cea\u554f<\/label><div class=\"div_textarea\"><textarea cols=\"20\" rows=\"5\" name=\"question\" id=\"question\" class=\"textarea\"><\/textarea><\/div><label for=\"others\" class=\"textarea\">\u5099\u8003<\/label><div class=\"div_textarea\"><textarea cols=\"20\" rows=\"5\" name=\"others\" id=\"others\" class=\"textarea\"><\/textarea><\/div><div class=\"gglcptch gglcptch_v3\"><input type=\"hidden\" id=\"g-recaptcha-response\" name=\"g-recaptcha-response\" \/><br \/><div 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