TravelJoy

Fred & Stacey Edwards

Integrity Elite Travel

2025 - Ujima #35 Charity Cruise - V2XQ09

Aug 14, 2025 to Aug 18, 2025

San Francisco, CA to Ensenada, Mexico

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		<field type="header" subtype="h2" label="2025 - Ujima #35 Charity Cruise Booking Form"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for registering for the 2025 - Ujima #35 Charity Cruise.&amp;nbsp; Your $75.00 per person tax deductible contribution will be directly donated to the Ujima #35 Charities."/>&#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="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Address" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Apt or Suite#" 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="Primary traveler's email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary traveler's phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Anniversary Date (if applicable)" name="anniversary-date-if-applicable" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many people (including yourself) will be in your cabin?" name="how-many-people-including-yourself-will-be-in-your-cabin" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are you a Carnival VIFP member?" name="are-you-a-carnival-vifp-member">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If you are a Carnival VIFP member, please provide your member number." name="if-you-are-a-carnival-vifp-member-please-provide-your-member-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Emergency Contact Information"/>&#13;
		<field type="text" required="true" label="Emergency Contact Name" name="text-1661802738964" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Emergency Contact Phone Number" name="text-1661802771570" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Companion Information"/>&#13;
		<field type="text" required="true" label="Full Legal Name of All Travel Companion(s)" name="spouse-partners-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Email Address(es) for All Travel Companions" name="text-1665965589749" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Date of Birth for All Travel Companion(s)" name="date-of-birth-for-all-travel-companions" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Cabin Details"/>&#13;
		<field type="text" required="true" label="Which cabin category do you want? (Interior, Oceanview or Balcony)" name="which-cabin-category-interior-oceanview-balcony-etc-please-be-specific" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Do you want your cabin as close to mid-ship as possible? (Additional cost approx. $75-$150 per person depending on cabin category)" name="do-you-want-your-cabin-as-close-to-midship-as-possible-additional-cost-approx-1050-per-person-depending-on-cabin-category">&#13;
			<option label="Yes, I want to be mid-ship" value="yes-i-want-to-be-midship">Yes, I want to be mid-ship</option>&#13;
			<option label="It doesn't matter to me... I'm just excited I'm going" value="it-doesnt-matter-to-me-im-just-excited-im-going">It doesn't matter to me... I'm just excited I'm going</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want to include pre-paid gratuities for the housekeeping and wait staff? (Please note if not purchased now they will be billed by cruise line at end of your trip). Cost is $64.00 per person." name="do-you-want-to-include-gratuities">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want to include Carnival Voyage Protection at an additional cost (highly recommended)? $79.00 per person for Interior cabins, $95.00 per person for Ocean View cabins and $95.00 per person for Balcony cabins." name="do-you-want-to-include-voyage-protection-at-an-additional-cost-recommended">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="How Do You Want Your Beds Configured?" name="how-do-you-want-your-beds-configured">&#13;
			<option label="Both/Together (Queen Bed)" value="bothtogether-queen-bed">Both/Together (Queen Bed)</option>&#13;
			<option label="Apart/Separate (Two Twin Beds)" value="apartseparate-two-twin-beds">Apart/Separate (Two Twin Beds)</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you need two separate invoices?" name="do-you-need-two-separate-invoices">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Any other info we need to know about your travel requirements or requests? Please make sure all names and dates of birth are correct." name="any-other-info-we-need-to-know-about-your-travel-interests" className="form-control"/>&#13;
	</fields>&#13;
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  </body>
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