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Alycia Schlegel
Taste of Bordeaux
France
<html> <body> <form-template> <fields> <field type="text" required="true" label="First name" name="first-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="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" label="Cabin Type Requested" name="cabin-type-requested"> <option label="Fixed Windows (170 sq. ft) starting at $3673 per person" value="fixed-windows-170-sq-ft-starting-at-3673-per-person">Fixed Windows (170 sq. ft) starting at $3673 per person</option> <option label="French Balcony (170 sq. ft) starting at $4972 per person" value="french-balcony-170-sq-ft-starting-at-4972-per-person">French Balcony (170 sq. ft) starting at $4972 per person</option> <option label="French Balcony (225 sq. ft) starting at $6372 per person" value="french-balcony-225-sq-ft-starting-at-6372-per-person">French Balcony (225 sq. ft) starting at $6372 per person</option> <option label="Suite - French Balcony (255 sq. ft) starting at $6672 per person" value="suite-french-balcony-255-sq-ft-starting-at-6672-per-person">Suite - French Balcony (255 sq. ft) starting at $6672 per person</option> </field> <field type="paragraph" subtype="blockquote" label="Prices are the total per person, based on double occupancy, including taxes.&nbsp; As always, prices and availability are subject to change at any time until a booking is confirmed."/> <field type="paragraph" subtype="p" label="Emergencies can happen when you least expect them. Journeys Travel Company, LLC highly recommends that all clients purchase a travel insurance policy to protect their investment in their travel. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. And, keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of trip cancellation, trip delay, trip interruption, missed connection, baggage loss, theft or damage, baggage delay, emergency medical and dental expenses, and emergency medical transportation, among other unforeseen circumstances."/> <field type="paragraph" subtype="p" label="Please also note that in order for you to obtain coverage for certain pre-existing conditions, or for supplier default, your policy must be purchased at the time of booking or shortly thereafter (depending on the terms of the policy)."/> <field type="radio-group" label="Do you want a quote for insurance?" name="do-you-want-a-quote-for-insurance"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Travel Documents"/> <field type="radio-group" required="true" label="Is everyone in your party a US citizen?" name="are-all-passengers-us-citizens"> <option label="yes" value="yes">yes</option> <option label="no" value="no">no</option> </field> <field type="radio-group" required="true" label="Does everyone have a passport book with at least 6 months' validity?&nbsp; A valid passport is required for this cruise." name="do-all-passengers-have-a-passport-book-with-at-least-6-months-validity"> <option label="yes" value="yes">yes</option> <option label="no" value="no">no</option> </field> <field type="header" subtype="h2" label="Passport Info"/> <field type="textarea" required="true" label="Full names and dates of birth for all guests (must match passports exactly)" name="full-names-and-dates-of-birth-for-all-guests-must-match-passports-exactly" className="form-control"/> <field type="header" subtype="h1" label="Medical and/or Dietary Notes"/> <field type="radio-group" required="true" label="Do you have any medical or dietary needs that should be noted (including pregnancy or plans to become pregnant)?&nbsp;&nbsp;" name="do-you-have-any-medical-or-dietary-needs-that-should-be-noted-including-pregnancy-or-plans-to-become-pregnant-"> <option label="yes" value="yes">yes</option> <option label="no" value="no">no</option> </field> <field type="textarea" label="If so, please explain:" name="if-so-please-explain" className="form-control"/> <field type="header" subtype="h1" label="Emergency Contact"/> <field type="text" label="Emergency contact name" name="emergency-contact-name" subtype="text" className="form-control"/> <field type="text" label="Emergency contact phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="clientLoyaltyPrograms" label="Cruise Loyalty Programs (I can look these numbers up with your names and dates of birth if you don't have them handy)." name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***"/> <field type="radio-group" label="Main Bedding Preference" name="bed-preference"> <option label="Queen/King" value="queenking">Queen/King</option> <option label="2 twins" value="2-twins">2 twins</option> </field> <field type="textarea" label="Additional notes/requests" name="additional-notesrequests" className="form-control"/> <field type="radio-group" required="true" label="I understand that it is vitally important that I read the information emailed to me by my advisor in order to be prepared for travel in the current climate. I also understand that I share the responsibility of remaining informed about the entry requirements for the destination(s) I am visiting. I will secure all necessary testing and complete all forms required for travel." name="i-understand-that-it-is-vitally-important-that-i-read-the-information-emailed-to-me-by-my-advisor-in-order-to-be-prepared-for-travel-in-the-current-climate-i-also-understand-that-i-share-the-responsibility-of-remaining-informed-about-the-entry-requirements-for-the-destinations-i-am-visiting-i-will-secure-all-necessary-testing-and-complete-all-forms-required-for-travel"> <option label="I agree" value="i-agree">I agree</option> <option label="I do not agree" value="i-do-not-agree">I do not agree</option> </field> </fields> </form-template> </body> </html>
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