TravelJoy

Marilyn Scott

Destinations For You Travel

202704 - Thailand

Apr 6, 2027 to Apr 15, 2027

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  <body>
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		<field type="header" subtype="h2" label="Reservation Form - Thailand"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="radio-group" required="true" label="Total Number of Guests in Room&amp;nbsp;" description="everyone staying in the room" name="total-number-of-guests-in-room-">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Roommate Name - enter N/A if you do not have one" name="roommate-name-enter-na-if-you-do-not-have-one" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How many travelers you are registering:" name="how-many-travelers-you-are-paying-for">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="WARNING: You are booking a Single Occupancy room . If this is not correct please select the correct number of guests in room.&amp;nbsp;" className="field-hidden"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;---------------------------"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1773118995804" rule="eyJ3aGVuRmllbGQiOiJ0b3RhbC1udW1iZXItb2YtZ3Vlc3RzLWluLXJvb20tIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6IjEiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicGFyYWdyYXBoLTIiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwYXJhZ3JhcGgtMiIsImxhYmVsIjoiV0FSTklORzogWW91IGFyZSBib29raW5nIGEgU2luZ2xlIE9jY3VwYW5jeSByb29tIC4gSWYgdGhpcyBpcyBub3QgY29ycmVjdCBwbGVhc2Ugc2VsZWN0IHRoZSBjb3JyZWN0IG51bWJlciBvZiBndWVzdHMgaW4gcm9vbS4mbmJzcDsifV19"/>&#13;
		<field type="header" subtype="h1" label="RESERVATION DETAILS"/>&#13;
		<field type="radio-group" required="true" label="Length of Trip" name="do-all-guests-included-on-this-reservation-reside-in-the-same-house">&#13;
			<option label="8D/7N Core Trip Bangkok and Chiang Mai" value="8d7n-core-trip-bangkok-and-chiang-mai">8D/7N Core Trip Bangkok and Chiang Mai</option>&#13;
			<option label="11D/10N Full Trip: Bangkok, Chiang Mai and Koh Samui" value="11d10n-full-trip-bangkok-chiang-mai-and-koh-samui">11D/10N Full Trip: Bangkok, Chiang Mai and Koh Samui</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp; &amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="header" subtype="h3" label="Primary Guest"/>&#13;
		<field type="text" required="true" label="First name (**Must be as it appears on Passport**)" 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 (**Must be as it appears on Passport**)" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" 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="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" name="gender">&#13;
			<option label="Male" value="male">Male</option>&#13;
			<option label="Female" value="female">Female</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="State of Residence" name="address-state" subtype="text" className="form-control"/>&#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="radio-group" required="true" label="T-Shirt Size" name="tshirt-size" other="true">&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="XLarge" value="xlarge">XLarge</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="XXLarge" value="xxlarge">XXLarge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Guest 2"/>&#13;
		<field type="text" label="Guest 2: First Name (**Must be as it appears on Passport**)" name="text-1771007242371" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Middle Name (**Must be as it appears on Passport**)" name="text-1771008145516" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Last Name (**Must be as it appears on Passport**)" name="text-1771007344420" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: State of Residence" name="guest-2-state-of-residence" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Guest 2: Email Address (**An Email Address is required to add them to the reservation**)" name="text-1771007546902" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Guest 2: Birthday (**Required for travel insurance and to determine if Guest is an adult or child**)" name="date-1771007907943" className="form-control"/>&#13;
		<field type="radio-group" label="Guest 2: Gender" name="guest-2-gender">&#13;
			<option label="Male" value="male">Male</option>&#13;
			<option label="Female" value="female">Female</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="T-Shirt Size" name="radio-group-1782229555478" other="true">&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="XLarge" value="xlarge">XLarge</option>&#13;
			<option label="Medium" value="medium">Medium</option>&#13;
			<option label="Small" value="small">Small</option>&#13;
			<option label="XXLarge" value="xxlarge">XXLarge</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Payment Information"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1773191199086" rule="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"/>&#13;
		<field type="header" subtype="h1" label="Guests Paying Separately"/>&#13;
		<field type="paragraph" subtype="p" label="This form will only allow you to add one credit card. If guests plan to pay separately, an invoice will be sent to the other party and must be authorized within 24 hours before the reservation can be considered confirmed."/>&#13;
		<field type="radio-group" required="true" label="Are guests paying separately for this reservation?" name="are-guests-paying-separately-for-this-reservation">&#13;
			<option label="No, I will pay the amount that is due now to reserve this reservation." value="no-i-will-pay-the-amount-that-is-due-now-to-reserve-this-reservation">No, I will pay the amount that is due now to reserve this reservation.</option>&#13;
			<option label="Yes, we will pay separately and submit the additional card info " value="yes-we-will-pay-separately-and-submit-the-additional-card-info-">Yes, we will pay separately and submit the additional card info </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Amount to Charge: Minimum Deposit Amount-$500 per person"/>&#13;
		<field type="paragraph" subtype="p" label="The deposit payment will be processed&amp;nbsp; 48-72 hours after you make your reservation.&amp;nbsp; You will receive confirmation, invoice and receipt to the email address you entered."/>&#13;
		<field type="radio-group" required="true" label="Please Select the Option Amount you are Authorizing" name="please-select">&#13;
			<option label="Pay $500 Per Person Now" value="pay-500-per-person-now">Pay $500 Per Person Now</option>&#13;
			<option label="Pay Full Amount of Room Reservation Now (Save 5%)" value="pay-full-amount-of-room-reservation-now-save-5">Pay Full Amount of Room Reservation Now (Save 5%)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Payment Schedule"/>&#13;
		<field type="checkbox-group" required="true" label="Acknowledge Below (Required)" name="checkbox-group-1771034738287">&#13;
			<option label="I acknowledge that 50% of remaining balance is due September 15th 2026 and the final payment is due by December 15, 2026. Periodic Payments of at least $250 may be made at any time. I understand missed payments could result in my reservation being cancelled. " value="i-acknowledge-that-50-of-remaining-balance-is-due-september-15th-2026-and-the-final-payment-is-due-by-december-15-2026-periodic-payments-of-at-least-250-may-be-made-at-any-time-i-understand-missed-payments-could-result-in-my-reservation-being-cancelled-">I acknowledge that 50% of remaining balance is due September 15th 2026 and the final payment is due by December 15, 2026. Periodic Payments of at least $250 may be made at any time. I understand missed payments could result in my reservation being cancelled. </option>&#13;
		</field>&#13;
	</fields>&#13;
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  </body>
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By booking your travel arrangement through us (DFY Travel LLC), you are agreeing to be bound by the terms of this agreement (“Agreement”) and any additional terms and conditions of any suppliers that are applicable to your booking arrangements. The lead guest, known as the "Primary Guest" on this reservation form assumes responsibility for sharing the Terms & Conditions with everyone in their reservation, including payment of all amounts when due.

I understand and acknowledge that all payments made are non-refundable and non-transferable
I certify that I am an authorized user of this credit card, and I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated.
I understand Debit Cards impose "Daily Charge Limits," and multiple payments may be needed to complete the full balance due, for which Destinations For You Travel will notify me if the situation occurs.
I consent to provide an electronic signature rather than a handwritten signature in connection with this authorization. By submitting my signature, I understand that my electronic signature will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization is accepted with the same authority as the original.
I agree to the TERMS and CONDITIONS of DFY Travel LLC d/b/a Destinations For You Travel,
Reservation occupancy level and invoice preference are based on the initial request. I understand the invoice amount represents my portion of the total package cost and agree that all roommates are ultimately responsible for the total cost of the package should there be a change in occupancy level. When financial agreements are made between occupants any monies due will be resolved directly among the occupants involved. Any refunds if applicable will be processed and applied to the credit card on file.
Authorization for the non-primary guest (paying separately) should click HERE

Payment Authorizations are typically processed within 72 hours of submitting the authorization.

By signing below, I authorize Destinations For You Travel to charge the credit card provided herein.

Click to sign