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Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR

Xhale Club Junior Suite Pool View - Double Occupancy —

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Total —

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Enter traveler information

Primary Traveler

INCOMPLETE

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		<field type="header" subtype="h2" label="Traveler&#39;s Full Name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" 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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" 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;
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		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="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" label="Line 2" name="address-line-2" 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" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Preferences"/>&#13;
		<field type="radio-group" required="true" label="Room Category" name="room-occupancy-">&#13;
			<option label="Single Occupancy (1 person in a room)" value="single-occupancy-1-person-in-a-room">Single Occupancy (1 person in a room)</option>&#13;
			<option label="Double Occupancy (2 people in a room)" value="double-occupancy-2-people-in-a-room">Double Occupancy (2 people in a room)</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Arrival Date" name="arrival-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="textarea" label="If sharing a room with someone, please indicate their first, last name(s) and email address(es) below:" name="if-sharing-a-room-with-someone-please-indicate-their-first-and-last-names-below" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="paragraph" subtype="p" label="Here are the passport requirements: Your passport must be valid for at least six months beyond your planned departure date. If you don’t have a passport yet, we recommend applying as soon as possible to allow enough processing time. If you already have a passport, please check the expiration date to ensure it meets the validity requirements. Your passport must be valid for at least six months beyond your planned departure date. If you don’t have a passport yet, we recommend applying as soon as possible to allow enough processing time. If you already have a passport, please check the expiration date to ensure it meets the validity requirements"/>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you aware of anything that might prevent you from traveling out of the country? (DUI, Child Custody, Fire Arms Incident, etc)" name="the-initial-deposit-of-50-per-person-100-for-single-occupancy-must-be-submitted-in-order-to-secure-your-reservation-indicate-below-how-you-will-be-submitting-the-payment">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Emergency Contact Information"/>&#13;
		<field type="text" required="true" label="Full Name" name="full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number (xxx-xxx-xxxx)" name="phone-number-xxxxxxxxxx" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Relationship to you" name="relationship-to-you" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Information"/>&#13;
		<field type="textarea" required="true" label="Do you have any dietary restrictions or food allergies?" name="do-you-have-any-dietary-restrictions-or-food-allergies" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Do you have any medical conditions we need to be aware of? Current medications.&amp;nbsp;" name="do-you-have-any-medical-conditions-we-need-to-be-aware-of-current-medications-" className="form-control"/>&#13;
		<field type="textarea" label="Please indicate any Special Requests below" name="please-indicate-any-special-requests-below" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you want a t-shirt" name="do-you-want-a-tshirt">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="If yes, what size t-shirt" name="if-yes-what-size-tshirt">&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="X-Large" value="xlarge">X-Large</option>&#13;
			<option label="XX-Large" value="xxlarge">XX-Large</option>&#13;
			<option label="XXX-Large" value="xxxlarge">XXX-Large</option>&#13;
			<option label="XXXX-Large" value="xxxxlarge">XXXX-Large</option>&#13;
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Click to sign

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Traveler&#39;s Full Name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" 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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" 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="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="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" label="Line 2" name="address-line-2" 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" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Preferences"/>&#13;
		<field type="radio-group" required="true" label="Room Category" name="room-occupancy-">&#13;
			<option label="Single Occupancy (1 person in a room)" value="single-occupancy-1-person-in-a-room">Single Occupancy (1 person in a room)</option>&#13;
			<option label="Double Occupancy (2 people in a room)" value="double-occupancy-2-people-in-a-room">Double Occupancy (2 people in a room)</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Arrival Date" name="arrival-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="textarea" label="If sharing a room with someone, please indicate their first, last name(s) and email address(es) below:" name="if-sharing-a-room-with-someone-please-indicate-their-first-and-last-names-below" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="paragraph" subtype="p" label="Here are the passport requirements: Your passport must be valid for at least six months beyond your planned departure date. If you don’t have a passport yet, we recommend applying as soon as possible to allow enough processing time. If you already have a passport, please check the expiration date to ensure it meets the validity requirements. Your passport must be valid for at least six months beyond your planned departure date. If you don’t have a passport yet, we recommend applying as soon as possible to allow enough processing time. If you already have a passport, please check the expiration date to ensure it meets the validity requirements"/>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you aware of anything that might prevent you from traveling out of the country? (DUI, Child Custody, Fire Arms Incident, etc)" name="the-initial-deposit-of-50-per-person-100-for-single-occupancy-must-be-submitted-in-order-to-secure-your-reservation-indicate-below-how-you-will-be-submitting-the-payment">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Emergency Contact Information"/>&#13;
		<field type="text" required="true" label="Full Name" name="full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number (xxx-xxx-xxxx)" name="phone-number-xxxxxxxxxx" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Relationship to you" name="relationship-to-you" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Information"/>&#13;
		<field type="textarea" required="true" label="Do you have any dietary restrictions or food allergies?" name="do-you-have-any-dietary-restrictions-or-food-allergies" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Do you have any medical conditions we need to be aware of? Current medications.&amp;nbsp;" name="do-you-have-any-medical-conditions-we-need-to-be-aware-of-current-medications-" className="form-control"/>&#13;
		<field type="textarea" label="Please indicate any Special Requests below" name="please-indicate-any-special-requests-below" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do you want a t-shirt" name="do-you-want-a-tshirt">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="If yes, what size t-shirt" name="if-yes-what-size-tshirt">&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="X-Large" value="xlarge">X-Large</option>&#13;
			<option label="XX-Large" value="xxlarge">XX-Large</option>&#13;
			<option label="XXX-Large" value="xxxlarge">XXX-Large</option>&#13;
			<option label="XXXX-Large" value="xxxxlarge">XXXX-Large</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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Deposit of $0.00 due on September 3, 2025

Monthly Payment #1 of $178.29 due on October 5, 2025

Monthly Payment #2 of $178.29 due on November 5, 2025

Monthly Payment #3 of $178.29 due on December 5, 2025

Monthly Payment #4 of $178.29 due on January 5, 2026

Monthly Payment #5 of $178.29 due on February 5, 2026

Monthly Payment #6 of $178.29 due on March 5, 2026

Final Payment of $178.26 due on April 5, 2026

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I authorize Xscape With Me Travel to charge the credit card provided herein by signing the form below. If payment has been made to Xscape With Me Travel by credit card, you agree not to seek to charge back your payment to Xscape With Me Travel. If Xscape With Me Travel incurs any costs, including but not limited to attorneys’ fees, to recover any payments charged back by your credit card company, you agree to be liable for these costs. If the credit card is declined, you guarantee that you will immediately settle any amounts owed to Xscape With Me Travel via money order or cash.

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Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR

Xhale Club Junior Suite Pool View - Double Occupancy —

—

Total —

Due now —

Continue to traveler info

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Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR

Xhale Club Junior Suite Pool View - Double Occupancy —

—

Total —

Due now —

Continue to traveler info

Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR

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Enter traveler information

Primary Traveler

INCOMPLETE

Credit Card Authorization

$0.00

Authorize full amount

$1,248.00

Punta Cana Takeover

Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR

Punta Cana Takeover

Jun 17, 2026 to Jun 21, 2026

Punta Cana, DR