TravelJoy

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Vacations - Destinations - Experiences

Riu Republica (LAT)

Dec 8, 2022 to Dec 12, 2022

Punta Cana, DR

<html>
  <body>
    <form-template>
	<fields>
		<field type="header" subtype="h2" label="Booking information"/>
		<field type="paragraph" subtype="p" label="Use this form if you want to go stay different days than March 16 - 20 OR if you want to make it a package with flights"/>
		<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="date" required="true" label="Birthday" name="birthday" className="form-control"/>
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="text" label="Phone number" placeholder="555-555-5555" name="phone-number" subtype="text" className="form-control"/>
		<field type="header" subtype="h1" label="Trip Information"/>
		<field type="radio-group" required="true" label="What are your preferred dates of travel?" name="what-are-your-preferred-dates-of-travel" other="true">
			<option label="March 16-20" value="march-1620">March 16-20</option>
			<option label="Other, please check below option" value="other-please-check-below-option" selected="selected">Other, please check below option</option>
		</field>
		<field type="radio-group" required="true" label="Room Type:" name="room-type">
			<option label="Resort View King" value="resort-view-king">Resort View King</option>
			<option label="Swim Up Double" value="swim-up-double">Swim Up Double</option>
			<option label="Grand Butler Suite " value="grand-butler-suite-">Grand Butler Suite </option>
		</field>
		<field type="select" required="true" label="Occupancy" name="occupancy" className="form-control">
			<option label="Single" value="single" selected="selected">Single</option>
			<option label="Double" value="double">Double</option>
			<option label="Triple" value="triple">Triple</option>
			<option label="Quad" value="quad">Quad</option>
		</field>
		<field type="text" label="Who are your roommates?" name="who-are-your-roommates" subtype="text" className="form-control"/>
		<field type="radio-group" required="true" label="Are any of your other roommates getting the flight package as well?" name="are-any-of-your-other-roommates-getting-the-flight-package-as-well">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
			<option label="I don't know" value="i-dont-know">I don't know</option>
			<option label="Not applicable" value="not-applicable">Not applicable</option>
		</field>
		<field type="text" required="true" label="What airport are you flying out of?" placeholder="HOU" name="what-airport-are-you-flying-out-of" subtype="text" className="form-control"/>
		<field type="text" label="Do you have a preferred airline?" name="do-you-have-a-preferred-airline" subtype="text" className="form-control"/>
		<field type="textarea" label="Please add any additional travel or flight requests" name="please-add-any-additional-travel-or-flight-requests" className="form-control"/>
		<field type="header" subtype="h1" label="Emergency Contact Information"/>
		<field type="text" required="true" label="Emergency Contact Name" placeholder="First Middle Last Suffix" name="guest-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Emergency Contact Phone Number" name="guest-date-of-birth" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Emergency Contact Relationship" name="guest-2-name" subtype="text" className="form-control"/>
	</fields>
</form-template>
  </body>
</html>