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Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Double Occupancy —

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Enter traveler information

Primary Traveler

INCOMPLETE

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		<field type="text" required="true" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
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		<field type="header" subtype="h2" label="Passport Information"/>&#13;
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			<option label="F" value="female">F</option>&#13;
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		<field type="text" required="true" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="TRIP INFORMATION"/>&#13;
		<field type="textarea" required="true" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Return Date" name="return-date" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you need airfare?" name="radio-group-1707583985576">&#13;
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			<option label="No, I don't want travel Insurance" value="No, I don't want travel Insurance">No, I don't want travel Insurance</option>&#13;
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			<option label="I have already purchased or denied my insurance. This is my vacation payment only" value="i-have-already-purchased-or-denied-my-insurance-this-is-my-vacation-payment-only">I have already purchased or denied my insurance. This is my vacation payment only</option>&#13;
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			<option label="NO" value="no">NO</option>&#13;
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		<field type="checkbox-group" required="true" label="Would you like us to match you with a roommate?" name="would-you-like-us-to-match-you-with-a-roommate">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
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		<field type="checkbox-group" required="true" label="What is your relationship with your roommate?" name="checkbox-group-1759778170061">&#13;
			<option label="Spouse" value="spouse">Spouse</option>&#13;
			<option label="Friend" value="friend">Friend</option>&#13;
			<option label="Son " value="son-">Son </option>&#13;
			<option label="Daughter" value="daughter">Daughter</option>&#13;
			<option label="Others (Please note at the chatbox)" value="others-please-note-at-the-chatbox">Others (Please note at the chatbox)</option>&#13;
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		<field type="textarea" required="true" label="Special Request" name="special-request" className="form-control"/>&#13;
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<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="text" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Information"/>&#13;
		<field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Emergency Contact Information"/>&#13;
		<field type="text" required="true" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="TRIP INFORMATION"/>&#13;
		<field type="textarea" required="true" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Return Date" name="return-date" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you need airfare?" name="radio-group-1707583985576">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="No">No</option>&#13;
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		<field type="text" required="true" label="Departure Airport" name="departure-airport" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Do you want to purchase travel insurance? Select one from the dropdown menu.*?" name="do-you-want-to-purchase-travel-insurance-select-one-from-the-dropdown-menu" className="form-control">&#13;
			<option label="No, I don't want travel Insurance" value="No, I don't want travel Insurance">No, I don't want travel Insurance</option>&#13;
			<option label="Yes, add travel insurance" value="Yes, add travel insurance">Yes, add travel insurance</option>&#13;
			<option label="I have already purchased or denied my insurance. This is my vacation payment only" value="i-have-already-purchased-or-denied-my-insurance-this-is-my-vacation-payment-only">I have already purchased or denied my insurance. This is my vacation payment only</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are you a Solo Traveler?" name="checkbox-group-1707851476221">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Then do you want to be introduced to a possible roommate match?&amp;nbsp;" name="checkbox-group-1741880020733">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like us to match you with a roommate?" name="would-you-like-us-to-match-you-with-a-roommate">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What is your relationship with your roommate?" name="checkbox-group-1759778170061">&#13;
			<option label="Spouse" value="spouse">Spouse</option>&#13;
			<option label="Friend" value="friend">Friend</option>&#13;
			<option label="Son " value="son-">Son </option>&#13;
			<option label="Daughter" value="daughter">Daughter</option>&#13;
			<option label="Others (Please note at the chatbox)" value="others-please-note-at-the-chatbox">Others (Please note at the chatbox)</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Special Request" name="special-request" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Continue to traveler info

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Final payment of $4,549.00 is due on April 20, 2026

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Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Double Occupancy —

—

Total —

Due now —

Continue to traveler info

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Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Double Occupancy —

—

Total —

Due now —

Continue to traveler info

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Select travelers

Select your package

Enter traveler information

Primary Traveler

INCOMPLETE

Credit Card Authorization

Authorize deposit

Final payment of $4,549.00 is due on April 20, 2026

$0.00

Authorize full amount

$4,549.00

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Select travelers

Select your package

Enter traveler information

Primary Traveler

INCOMPLETE

Credit Card Authorization

Authorize deposit Final payment of $4,549.00 is due on April 20, 2026

$0.00

Authorize full amount

$4,549.00

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Premier World Cuba Discovery (Land Tour) Tour Date: April 20 – 25, 2026

Apr 20, 2026 to Apr 25, 2026

Authorize deposit

Final payment of $4,549.00 is due on April 20, 2026