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2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Balcony View Stateroom Double occupancy —

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Total —

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INCOMPLETE

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			<option label="No" value="no">No</option>
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		<field type="text" label="If yes, what is the full name_____________________________________?&amp;nbsp; &amp;nbsp;What is your loyalty #_______________________________________?" name="text-1622569777004" subtype="text" className="form-control"/>
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		<field type="textarea" label="Please share any dietary restrictions." name="textarea-1621284170388" className="form-control"/>
		<field type="textarea" label="Please list any special accommodiations you may need:" name="textarea-1621284183769" className="form-control"/>
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			<option label="Small" value="small">Small</option>
			<option label="Medium" value="medium">Medium</option>
			<option label="Large" value="large">Large</option>
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			<option label="XX-Large" value="xxlarge">XX-Large</option>
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<html>
  <body>
    <form-template>
	<fields>
		<field type="header" subtype="h1" label="Cruiser, tell us about you..."/>
		<field type="paragraph" subtype="p" label="Please complete the form below so that we can get to know you better."/>
		<field type="paragraph" subtype="p" label="Provide your legal name as it appears on your Government-issued ID:"/>
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>
		<field type="text" label="Valid Email address:" name="email" subtype="text" className="form-control"/>
		<field type="paragraph" subtype="p" label="Address:"/>
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		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>
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		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Cell phone number (xxx-xxx-xxxx)" name="phone-number" subtype="text" className="form-control"/>
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			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
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		<field type="text" label="If yes, what is the full name_____________________________________?&amp;nbsp; &amp;nbsp;What is your loyalty #_______________________________________?" name="text-1622569777004" subtype="text" className="form-control"/>
		<field type="radio-group" label="Cruise Line promotional qualifiers.&amp;nbsp; Select all that are applicable:" name="cruise-line-promotional-qualifiers-select-all-that-is-applicable">
			<option label="Age 55+" value="age-55">Age 55+</option>
			<option label="Law Enforcement" value="law-enforcement">Law Enforcement</option>
			<option label="Fire Department or EMT" value="fire-department-or-emt">Fire Department or EMT</option>
			<option label="U. S. Military" value="u-s-military">U. S. Military</option>
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			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
			<option label="Single Occupancy" value="single-occupancy">Single Occupancy</option>
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		<field type="text" label="If yes,&amp;nbsp; list below the name of the person who will share your cabin.&amp;nbsp;&amp;nbsp;" name="text-1621284144178" subtype="text" className="form-control"/>
		<field type="textarea" label="Please share any dietary restrictions." name="textarea-1621284170388" className="form-control"/>
		<field type="textarea" label="Please list any special accommodiations you may need:" name="textarea-1621284183769" className="form-control"/>
		<field type="text" required="true" label="Emergency contact name:" name="emergency-contact-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Emergency contact cell phone #:" name="emergency-contact-cell-phone-" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Emergency contact relationship to you:" name="emergency-contact-relationship-to-you" subtype="text" className="form-control"/>
		<field type="radio-group" label="Provide your t-shirt size:" name="radio-group-1621284050003" other="true">
			<option label="Small" value="small">Small</option>
			<option label="Medium" value="medium">Medium</option>
			<option label="Large" value="large">Large</option>
			<option label="X-Large" value="xlarge">X-Large</option>
			<option label="XX-Large" value="xxlarge">XX-Large</option>
			<option label="XXX-Large" value="xxxlarge">XXX-Large</option>
			<option label="XXXX-Large" value="xxxxlarge">XXXX-Large</option>
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Continue to traveler info

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Balcony View Stateroom Double occupancy —

—

Total —

Due now —

Continue to traveler info

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Deposit of $0.00 due on September 3, 2025

Monthly Payment #1 of $61.19 due on September 15, 2025

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Final Payment of $61.15 due on December 15, 2026

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Note: By paying, you agree to the following Terms & Conditions

I authorize Inspired 2 Travel, LLC to charge the credit card or bank account indicated on this invoice for the noted amount on the dates indicated. I understand that my right to a refund in the event of cancellation is governed by the cancellation and refund policy in Inspired 2 Travel, LLC Terms and Conditions of Booking. I certify that I am an authorized user of this credit card and that I agree to Inspired 2 Travel, LLC Terms and Conditions of Booking, and I will not dispute the payment with my credit card company so long as the transaction corresponds to the amount and terms on this invoice.

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2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Balcony View Stateroom Double occupancy —

—

Total —

Due now —

Continue to traveler info

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Select travelers

Select your package

Add extra options

Enter traveler information

Primary Traveler

INCOMPLETE

2027 Dual Support Healing Retreat Cruise

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

How would you like to pay?

Payment Type

Credit card

Bank transfer
Your bank info will be collected on the next page.

Payment schedule

$0.00

Save time and turn on auto-pay?

Pay full amount

$979.00

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Select travelers

Select your package

Add extra options

Enter traveler information

Primary Traveler

INCOMPLETE

2027 Dual Support Healing Retreat Cruise

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

How would you like to pay?

Payment Type

Credit card

Bank transfer Your bank info will be collected on the next page.

Payment schedule

$0.00

Save time and turn on auto-pay?

Pay full amount

$979.00

2027 Dual Support Healing Retreat Cruise

Apr 8, 2027 to Apr 12, 2027

Cozumel, Mexico

Bank transfer
Your bank info will be collected on the next page.