TravelJoy

Dr. Stacey Edwards

Integrity Elite Travel

2027 Land & Sea Trip ~ Alaska Dawes Glacier

Jul 29, 2027 to Aug 6, 2027

Alaska

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		<field type="header" subtype="h1" label="8 Night Land &amp;amp; Sea Trip ~ Alaska Dawes Glacier (7/29/27 - 8/6/27). Initial deposit is $500.00 per cabin. Trip includes 7 night Alaska Dawes Glacier cruise on Celebrity Edge, 1 pre-night stay at a 4 star hotel in Seattle, WA and ground transfer from hotel to cruise terminal. Ports of call include: Ketchikan, Endicott Arm, Juneau &amp;amp; Skagway, AK; Alaska Inside Passage and Victoria, BC."/>&#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 email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary 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" required="true" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="Other" value="other">Other</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="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="radio-group" required="true" label="Gender - Second Traveler" name="radio-group-1768266122179">&#13;
			<option label="F" value="f">F</option>&#13;
			<option label="M" value="m">M</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are you or the other traveler(s) a member(s) of Celebrity Cruises frequent traveler club?" name="checkbox-group-1768265297225">&#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="Are you a member / employee of any of these organizations?" name="are-you-a-member-employee-of-any-of-these-organizations">&#13;
			<option label="Active Duty Military" value="active-duty-military">Active Duty Military</option>&#13;
			<option label="Military Veteran" value="military-veteran">Military Veteran</option>&#13;
			<option label="Firefighter / EMT" value="firefighter-emt">Firefighter / EMT</option>&#13;
			<option label="Police Officer" value="police-officer">Police Officer</option>&#13;
			<option label="None of the Above" value="none-of-the-above">None of the Above</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Which cabin category are you interested in? Please note below pricing is based on double occupancy and is subject to change.&amp;nbsp;" name="checkbox-group-1768265428937">&#13;
			<option label="Interior Stateroom (starting at $3,164 per cabin)" value="interior-stateroom-starting-at-3164-per-cabin">Interior Stateroom (starting at $3,164 per cabin)</option>&#13;
			<option label="Ocean View Stateroom (starting at $3,771 per cabin)" value="ocean-view-stateroom-starting-at-3771-per-cabin">Ocean View Stateroom (starting at $3,771 per cabin)</option>&#13;
			<option label="Prime Ocean View Stateroom (starting at $3,992 per cabin)" value="prime-ocean-view-stateroom-starting-at-3992-per-cabin">Prime Ocean View Stateroom (starting at $3,992 per cabin)</option>&#13;
			<option label="Deluxe Ocean View Stateroom (starting at $4,405 per cabin)" value="deluxe-ocean-view-stateroom-starting-at-4405-per-cabin">Deluxe Ocean View Stateroom (starting at $4,405 per cabin)</option>&#13;
			<option label="Panoramic Ocean View Stateroom (starting at $4,816 per cabin)" value="panoramic-ocean-view-stateroom-starting-at-4816-per-cabin">Panoramic Ocean View Stateroom (starting at $4,816 per cabin)</option>&#13;
			<option label="Edge Stateroom with Infinite Veranda (starting at $5,451 per cabin)" value="edge-stateroom-with-infinite-veranda-starting-at-5451-per-cabin">Edge Stateroom with Infinite Veranda (starting at $5,451 per cabin)</option>&#13;
			<option label="Prime Edge Stateroom with Infinite Veranda (starting at $6,419 per cabin)" value="prime-edge-stateroom-with-infinite-veranda-starting-at-6419-per-cabin">Prime Edge Stateroom with Infinite Veranda (starting at $6,419 per cabin)</option>&#13;
			<option label="Sunset Veranda Stateroom (starting at $6,657 per cabin)" value="sunset-veranda-stateroom-starting-at-6657-per-cabin">Sunset Veranda Stateroom (starting at $6,657 per cabin)</option>&#13;
			<option label="Concierge Class Stateroom (starting at $5,761 per cabin)" value="concierge-class-stateroom-starting-at-5761-per-cabin">Concierge Class Stateroom (starting at $5,761 per cabin)</option>&#13;
			<option label="Prime Concierge Class Stateroom (starting at  $5,897 per cabin)" value="prime-concierge-class-stateroom-starting-at-5897-per-cabin">Prime Concierge Class Stateroom (starting at  $5,897 per cabin)</option>&#13;
			<option label="AquaClass Stateroom (starting at  $6,920 per cabin)" value="aquaclass-stateroom-starting-at-6920-per-cabin">AquaClass Stateroom (starting at  $6,920 per cabin)</option>&#13;
			<option label="Prime AquaClass Stateroom (starting at  $7,551 per cabin)" value="prime-aquaclass-stateroom-starting-at-7551-per-cabin">Prime AquaClass Stateroom (starting at  $7,551 per cabin)</option>&#13;
			<option label="Suites (starting at $11,095 per cabin. Please contact me to discuss suite options)" value="suites-starting-at-11095-per-cabin-please-contact-me-to-discuss-suite-options">Suites (starting at $11,095 per cabin. Please contact me to discuss suite options)</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;
			<option label="We are booking a triple/quad that includes a sofa bed or trundle bed" value="we-are-booking-a-triplequad-that-includes-a-sofa-bed-or-trundle-bed">We are booking a triple/quad that includes a sofa bed or trundle bed</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you have a deck preference?&amp;nbsp; Or would you prefer to be on the deck with most of the group? If you have a preference please note which deck below. Please be advised that all room categories are not available on all decks and are based upon availability." name="text-1768265927289" 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. $50.00 - $100.00 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? Please note if not purchased now they will be billed by cruise line at end of your trip. ($252.00 to $266.00 per room based on double occupancy)" 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 voyage protection at an additional cost (highly recommended)? Starting at $198.00 per room based on cabin category)" 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="What dining time do you prefer?" name="what-dining-time-do-you-prefer">&#13;
			<option label="Early (6:00pm)" value="early-600pm">Early (6:00pm)</option>&#13;
			<option label="Late (8:30pm)" value="late-830pm">Late (8:30pm)</option>&#13;
			<option label="Anytime (from 6:00pm - 9:00pm)" value="anytime-from-600pm-900pm">Anytime (from 6:00pm - 9:00pm)</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Do you want to purchase a ground transfer from the cruise terminal in British Columbia to Victoria International Airport upon your cruise return (Approx. $65-$95 per person)?&amp;nbsp;" name="will-you-require-separate-invoices-for-each-traveller">&#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="Will you require separate invoices for each traveller?" name="checkbox-group-1779138703217">&#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?" name="any-other-info-we-need-to-know-about-your-travel-interests" className="form-control"/>&#13;
	</fields>&#13;
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