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Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Sanctuary Jr Suite Queen —

—

Total —

Due now —

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Enter traveler information

Primary Traveler (adult)

INCOMPLETE

<html>
  <body>
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	<fields>&#13;
		<field type="header" subtype="h1" label="Group Reservation Form *Alyssa and Lee&#39;s Wedding*"/>&#13;
		<field type="paragraph" subtype="p" label="Submitting information via this reservation form DOES NOT automatically confirm your reservation, or charge your credit card. Bohemia Wedding Travel will email you a confirmation of your payment invoice after the booking form has been reviewed and payment processed correctly."/>&#13;
		<field type="paragraph" subtype="p" label="Please enter your legal name(s) EXACTLY as it appears on your valid passport. Bohemia Wedding Travel is not liable if the information below is not entered correctly. "/>&#13;
		<field type="paragraph" subtype="p" label="It is your responsibility to review the invoice upon receipt to ensure 100% accuracy. Please check thoroughly for any discrepancies or errors. Bohemia Wedding Travel is NOT responsible for errors, or any fees associated with necessary changes after 24 hours of receipt. "/>&#13;
		<field type="header" subtype="h1" label="Additional Information"/>&#13;
		<field type="select" required="true" label="Total Number Of Guests In Your Room&amp;nbsp;" name="total-number-of-guests-in-room-john-and-jane-wedding" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
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		<field type="text" label="Please provide any additional comments you want us to know here, including if anyone in this room may need a disability room.&amp;nbsp;" name="please-provide-any-additional-comments-you-want-us-to-know-here-including-if-anyone-in-this-room-may-need-a-disability-room-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Primary Guest&#39;s Full Name"/>&#13;
		<field type="paragraph" subtype="p" label="The Primary Guest is the person who will be making the payments. All additional guests can be added below."/>&#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="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Primary Guest&#39;s Birthday" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Primary Guest 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" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Primary Guest&#39;s Contact Info:"/>&#13;
		<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="text" required="true" label="Emergency Contact Info" description="Full Name + Phone Number" name="emergency-contact-info" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="&amp;nbsp;Dietary Requests, Restrictions and Requirements"/>&#13;
		<field type="checkbox-group" required="true" label="Bohemia Wedding Travel does not assume responsibility for identifying, communicating, monitoring, accommodating, or ensuring compliance with any guest dietary requirements, food allergies, food sensitivities, medical conditions, or dietary restrictions. As we are not affiliated with, nor responsible for, the on-site food and beverage operations of the hotel, resort, venue, caterer, or any third-party service provider, we cannot guarantee that any dietary requests will be received, accommodated, or fulfilled. All guests are responsible for communicating dietary requirements in person with hotel or resort staff." inline="true" name="checkbox-group-1782773354811">&#13;
			<option label="I understand the dietary terms" value="i-understand-the-dietary-terms">I understand the dietary terms</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Reservation Payment Dates:"/>&#13;
		<field type="paragraph" subtype="p" label="I agree and acknowledge the following required payment dates:"/>&#13;
		<field type="paragraph" subtype="p" label="$300 non-refundable deposit is due at booking"/>&#13;
		<field type="paragraph" subtype="p" label="July 28th, 2027 - 2 nights of your room total is due"/>&#13;
		<field type="paragraph" subtype="p" label="November 25th, 2027 – Remaining balance is due"/>&#13;
		<field type="checkbox-group" required="true" label="I understand these terms" inline="true" name="check-if-you-acknowledge-and-understand">&#13;
			<option label="I Acknowledge And Understand These Terms." value="i-acknowledge-and-understand-these-terms">I Acknowledge And Understand These Terms.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Price Match Policy"/>&#13;
		<field type="paragraph" subtype="p" label="The room block is limited to a maximum of two (2) group-wide price match requests. Any price match request must be submitted to Bohemia Wedding Travel before July 28, 2027 and must meet all applicable price match requirements. Price match requests submitted after this date will not be accepted."/>&#13;
		<field type="paragraph" subtype="p" label="Price matches are not guaranteed and are subject to availability and written approval by the resort or supplier. Rates offered through third-party websites, membership or loyalty programs, mobile applications, package promotions, promotional codes, flash sales, or other restricted offers do not qualify."/>&#13;
		<field type="paragraph" subtype="p" label="Once the two permitted group-wide price match requests have been submitted, no additional requests from the wedding couple or individual guests will be reviewed."/>&#13;
		<field type="checkbox-group" required="true" label="Please Check If You Acknowledge Below:" inline="true" name="price-match-policy-acknowledgment">&#13;
			<option label="I acknowledge and understand the Group Price Match Policy and agree that no more than two group-wide price match requests may be submitted." value="i-acknowledge-price-match-policy">I acknowledge and understand the Group Price Match Policy and agree that no more than two group-wide price match requests may be submitted.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Three-Night Minimum Stay Requirement"/>&#13;
		<field type="paragraph" subtype="p" label="A minimum stay of three (3) nights is required for every reservation and for each guest included in the reservation. This is a mandatory and non-negotiable requirement under the group contract and the room block terms and conditions."/>&#13;
		<field type="paragraph" subtype="p" label="Reservations for fewer than three nights cannot be accepted. After a reservation has been confirmed, the number of nights or guests cannot be reduced if the change would cause the reservation or any guest&#39;s stay to fall below the required three-night minimum."/>&#13;
		<field type="checkbox-group" required="true" label="Please Check If You Acknowledge Below:" inline="true" name="three-night-minimum-stay-acknowledgment">&#13;
			<option label="I acknowledge and understand that a minimum stay of three (3) nights is required for my reservation and for every guest included in my reservation." value="i-acknowledge-three-night-minimum">I acknowledge and understand that a minimum stay of three (3) nights is required for my reservation and for every guest included in my reservation.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Protection (Important: Please Read, Not Included in Room Rate)"/>&#13;
		<field type="paragraph" subtype="p" label="Having travel insurance is definitely important and we recommend it for everyone. Depending on the option you chose it may cover trip cancellation and many other things like unexpected medical expenses, baggage and flight delays. "/>&#13;
		<field type="paragraph" subtype="p" label="By selecting and signing below, I acknowledge that I have been provided information and given the opportunity to purchase Travel Protection and understand that declining travel protection could result in the loss of my travel cost and/or require more money to correct the situation. I also acknowledge that without the protection, there may be no way to recoup any losses, costs or expenses incurred and the price of Travel Protection IS NOT included in my price and is non-refundable."/>&#13;
		<field type="paragraph" subtype="p" label="Bohemia Wedding Travel is not a licensed Insurance Agency and therefore cannot answer questions regarding any travel insurance policies. The option to add travel insurance is solely for your convenience. If you would like to check on Travel Protection for your trip please visit this website, https://www.travelinsured.com/ (copy and paste the link in your browser). This is the insurance company we personally like and suggest but you are welcome to purchase Travel Protection through any entity that you choose."/>&#13;
		<field type="checkbox-group" required="true" label="Please Acknowledge Below:" inline="true" name="please-acknowledge-below">&#13;
			<option label="I acknowledge that I have been advised about purchasing Travel Protection &amp; that it is not included in the price of my reservation." value="i-acknowledge-that-i-have-been-advised-about-purchasing-travel-protection-that-it-is-not-included-in-the-price-of-my-reservation">I acknowledge that I have been advised about purchasing Travel Protection &amp; that it is not included in the price of my reservation.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Room Reservation Cancellation Policy"/>&#13;
		<field type="paragraph" subtype="p" label="Once a reservation is booked there is a NON REFUNDABLE $300 per room cancellation fee (taken from initial deposit) with no regard to the reason for the cancellation. This cancellation fee cannot be reapplied to a later re-booking."/>&#13;
		<field type="paragraph" subtype="p" label="If you purchased the travel insurance and have to cancel you will be refunded by the travel insurance company according to the travel insurance guidelines, but you are still responsible for the $300 per room cancellation fee (taken from initial deposit)."/>&#13;
		<field type="paragraph" subtype="p" label="If you do not purchase travel insurance and have to cancel your reservation you may still have to pay for part or the full amount of your reservation."/>&#13;
		<field type="paragraph" subtype="p" label="Bohemia Wedding Travel is not an agent of the Hotel and has no control over refund policies and other rules mandated by the Hotel."/>&#13;
		<field type="paragraph" subtype="p" label="If you cancel your reservation before July 28th, 2027 you are only responsible for the non-refundable $300 per room booking fee already paid as the deposit when you reserved your room. However, you can reduce the number of nights in your reservation up to this date without a fee (maintaining the 3 night minimum)."/>&#13;
		<field type="paragraph" subtype="p" label="If you cancel your reservation between July 28th, 2027 and October 28th, 2027, any room nights or guests cancelled will be charged at 1 night per person, based on your room&#39;s occupancy and category."/>&#13;
		<field type="paragraph" subtype="p" label="If you cancel your reservation between October 29th, 2027 and November 26th, 2027, any room nights or guests cancelled will be charged at 2 nights per person, based on your room&#39;s occupancy and category."/>&#13;
		<field type="paragraph" subtype="p" label="If you cancel your reservation, no show or reduce the number of nights or travelers in your reservation after November 26th, 2027, you are responsible for 100% of your room total."/>&#13;
		<field type="paragraph" subtype="p" label="If you have travel insurance you may file a claim to get a refund based on the insurance providers terms."/>&#13;
		<field type="paragraph" subtype="p" label="The resort will not provide a credit or voucher for future travel if you arrive after your scheduled arrival date, if you check out early, or do not travel on the dates selected for this reservation for any reason."/>&#13;
		<field type="checkbox-group" required="true" label="Please Check If You Acknowledge Below:" inline="true" name="please-check-if-you-acknowledge-below">&#13;
			<option label="I have read and understand the Room Cancellation Policy." value="i-have-read-and-understand-the-room-cancellation-policy">I have read and understand the Room Cancellation Policy.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Room Reassignment Policy&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="July 28th, 2027 is the last date permitted to reassign the name(s) of guest in booking. * Name changes are subject to supplier policy/acceptance. More than one name change per room on a reservation is considered a cancel/rebook and can be subject to new rates."/>&#13;
		<field type="header" subtype="h1" label="Date Shifting Policy"/>&#13;
		<field type="paragraph" subtype="p" label="July 28, 2027 is the last date permitted to shift or change dates booked within your reservation. Subject to availability. Further room nights may be added after this date but may be subject to availability and possible new rates. "/>&#13;
		<field type="checkbox-group" required="true" label="Please Check If You Acknowledge Below:" name="i-understand-that-every-attendee-needs-a-passport-to-enter-the-country">&#13;
			<option label="I have read and understand the Room Cancellation, Room Reassignment and Date Shifting Policies." value="i-have-read-and-understand-the-room-cancellation-room-reassignment-and-date-shifting-policies">I have read and understand the Room Cancellation, Room Reassignment and Date Shifting Policies.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Requirements and Restrictions"/>&#13;
		<field type="checkbox-group" required="true" label="I understand that due to any and all COVID-19 developments, changes to travel requirements &amp;amp; restrictions can occur at any time and are completely out of the control of Bohemia Wedding Travel." inline="true" name="checkbox-group-1740376728187">&#13;
			<option label="I Understand." value="i-understand">I Understand.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Passport Required"/>&#13;
		<field type="paragraph" subtype="p" label="Also, I acknowledge that everyone staying within my reservation currently has a Passport that is valid for at least 6 months after the return date of my reservation or will obtain one before departure."/>&#13;
		<field type="paragraph" subtype="p" label="I understand that everyone (including children) staying within my reservation and attending this event must have a valid Passport to enter and exit the country."/>&#13;
		<field type="checkbox-group" required="true" label="I understand that every attendee needs a Passport to enter and exit the country." name="checkbox-group-1740376937269">&#13;
			<option label="I Understand." value="i-understand">I Understand.</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Multiple or Monthly Payment Options:"/>&#13;
		<field type="paragraph" subtype="p" label="After you pay the deposit to reserve your room, you will receive an invoice via your email. You can &#39;Reply&#39;, scroll down to the invoice link and make custom payment amounts, with the same or different credit cards anytime as long as you&#39;re meeting the scheduled payments due. Each payment you make will deduct from your remaining balance."/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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Credit Card Authorization

Select the amount you would like to authorize:

Authorize deposit

Deposit of $300.00 due on September 16, 2026

Alyssa & Lee - 2 Nights of Total of $679.38 due on July 28, 2027

Alyssa & Lee - Final Balance of $34.62 due on November 25, 2027

$300.00

Authorize full amount

$1,014.00

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By signing below, I authorize Bohemia Wedding Travel to charge the credit card provided herein.

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Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Sanctuary Jr Suite Queen —

—

Total —

Due now —

Continue to traveler info

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Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Sanctuary Jr Suite Queen —

—

Total —

Due now —

Continue to traveler info

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Select travelers & dates

Select your package

Enter traveler information

Primary Traveler (adult)

INCOMPLETE

Credit Card Authorization

Authorize deposit

Deposit of $300.00 due on September 16, 2026

Alyssa & Lee - 2 Nights of Total of $679.38 due on July 28, 2027

Alyssa & Lee - Final Balance of $34.62 due on November 25, 2027

$300.00

Authorize full amount

$1,014.00

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Select travelers & dates

Select your package

Enter traveler information

Primary Traveler (adult)

INCOMPLETE

Credit Card Authorization

Authorize deposit Deposit of $300.00 due on September 16, 2026 Alyssa & Lee - 2 Nights of Total of $679.38 due on July 28, 2027 Alyssa & Lee - Final Balance of $34.62 due on November 25, 2027

$300.00

Authorize full amount

$1,014.00

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Alyssa Plassman and Lee Jackson Wedding | Agent - Ana Santos | ana@bohemiaweddingtravel.com

Feb 17, 2028 to Feb 21, 2028

Garza Blanca Preserve Resort Puerto Vallarta

Authorize deposit

Deposit of $300.00 due on September 16, 2026

Alyssa & Lee - 2 Nights of Total of $679.38 due on July 28, 2027

Alyssa & Lee - Final Balance of $34.62 due on November 25, 2027