TravelJoy

Tracy Ballagh

Faugh A Ballagh Travel

AMAWaterways - Essence of Burgundy & Provence

Oct 8, 2026 to Oct 15, 2026

AMAWaterways - Essence of Burgundy & Provence

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		<field type="header" subtype="h1" label="WELCOME to FAUGH a BALLAGH TRAVEL"/>&#13;
		<field type="header" subtype="h1" label="THANK YOU for your interest in learning more about this amazing AMAWaterways River Cruise. &amp;nbsp;Please complete this form and I will be in touch."/>&#13;
		<field type="paragraph" subtype="p" label="----------------"/>&#13;
		<field type="paragraph" subtype="p" label="7-Night Cruise from Arles to Dijon, France"/>&#13;
		<field type="paragraph" subtype="p" label="Indulge in French flavors on a palate-pleasing itinerary that highlights the essence of France’s Burgundy and Provence. Uncover the Roman history of Chalon-sur Saône and delight in charming Tournus with its towering Romanesque abbey and historic apothecary shop. Visit French châteaux from Burgundy to Provence, taste your way through the French culinary capital of Lyon and visit the Papal Palace in Avignon. While you’ll get more than a taste of Burgundy and Provence during this itinerary, the essence of these destinations will linger on your palate – and in your heart – for a lifetime!"/>&#13;
		<field type="paragraph" subtype="p" label="----------------"/>&#13;
		<field type="paragraph" subtype="p" label="CRUISE FROM: PORT OF DIJON TO ARLES"/>&#13;
		<field type="paragraph" subtype="p" label="RIVERS: Rhone, Saone"/>&#13;
		<field type="header" subtype="h2" label="Full name&amp;nbsp;"/>&#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="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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="What Cabin Category are you interested in?"/>&#13;
		<field type="radio-group" required="true" label="Cabin Category" description="Cabins listed in order of pricing and does not include potential group discounts (based on deposit date) or military discounts ($100/person w/military ID).  Single supplements are typically 50%." name="cabin-category">&#13;
			<option label="Suite, (255 sq ft)" value="suite-255-sq-ft">Suite, (255 sq ft)</option>&#13;
			<option label="French Balcony, Category A (170 sq ft)" value="french-balcony-category-a-170-sq-ft">French Balcony, Category A (170 sq ft)</option>&#13;
			<option label="French Balcony, Category B (170 sq ft)" value="french-balcony-category-b-170-sq-ft">French Balcony, Category B (170 sq ft)</option>&#13;
			<option label="French Balcony, Category C (170 sq ft)" value="french-balcony-category-c-170-sq-ft">French Balcony, Category C (170 sq ft)</option>&#13;
			<option label="Fixed Windows, Category D (170 sq ft)" value="fixed-windows-category-d-170-sq-ft">Fixed Windows, Category D (170 sq ft)</option>&#13;
			<option label="Fixed Windows, Category E (170 sq ft)" value="fixed-windows-category-e-170-sq-ft">Fixed Windows, Category E (170 sq ft)</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you interested in a Pre-Cruise or Post-Cruise Option?" description="AMA Pre- and Post-Cruise option include Hotel Stay  Breakfast  Tours &amp; Transportation to the ship" name="are-you-interested-in-a-precruise-option">&#13;
			<option label="Yes, PRE-Cruise (3 Nights Nice) $ 1590/person" value="yes-precruise-3-nights-nice-1590person">Yes, PRE-Cruise (3 Nights Nice) $ 1590/person</option>&#13;
			<option label="Yes, POST-Cruise (3 Nights Geneva) $1590/person" value="yes-postcruise-3-nights-geneva-1590person">Yes, POST-Cruise (3 Nights Geneva) $1590/person</option>&#13;
			<option label="Yes, BOTH Pre &amp; Post Cruise options" value="yes-both-pre-post-cruise-options">Yes, BOTH Pre &amp; Post Cruise options</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do any of these Options Apply to you? &amp;nbsp;Additional discounts may apply." name="do-any-of-these-options-apply-to-you-additional-discounts-may-apply">&#13;
			<option label="I currently hold an active or retired military ID" value="i-currently-hold-an-active-or-retired-military-id">I currently hold an active or retired military ID</option>&#13;
			<option label="I am currently a first responder or health care worker" value="i-am-currently-a-first-responder-or-health-care-worker">I am currently a first responder or health care worker</option>&#13;
			<option label="I have cruised with AMA before and have an AMA loyalty number" value="i-have-cruised-with-ama-before-and-have-an-ama-loyalty-number">I have cruised with AMA before and have an AMA loyalty number</option>&#13;
			<option label="I have a true AMEX platinum credit card (not an airline platinum AMEX)" value="">I have a true AMEX platinum credit card (not an airline platinum AMEX)</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Travel Insurance" description="NOTE:  AMA travel insurance must be paid at time of deposit and is not refundable  even if canceling before the pay in full date." name="travel-insurance">&#13;
			<option label="Include AMA Waterways travel protection to my quote (13%) PLUS the $80 Cancel for Any Reason future cruise credit option" value="include-ama-waterways-travel-protection-to-my-quote-13-plus-the-80-cancel-for-any-reason-future-cruise-credit-option">Include AMA Waterways travel protection to my quote (13%) PLUS the $80 Cancel for Any Reason future cruise credit option</option>&#13;
			<option label="Include AMA Waterways travel protection to my quote (13%)" value="include-ama-waterways-travel-protection-to-my-quote-13">Include AMA Waterways travel protection to my quote (13%)</option>&#13;
			<option label="I would prefer an Allianz travel insurance quote" value="i-would-prefer-an-allianz-travel-insurance-quote">I would prefer an Allianz travel insurance quote</option>&#13;
			<option label="I do not wish to add travel insurance at this time" value="i-do-not-wish-to-add-travel-insurance-at-this-time">I do not wish to add travel insurance at this time</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="AMA Ground Transportation Options" name="ama-ground-transportation-options">&#13;
			<option label="Include AMA ground transportation from the Airport to the Ship (Same Day)" value="include-ama-ground-transportation-from-the-airport-to-the-ship-same-day">Include AMA ground transportation from the Airport to the Ship (Same Day)</option>&#13;
			<option label="Include AMA ground transportation from the Ship to the Airport (Same Day)" value="include-ama-ground-transportation-from-the-ship-to-the-airport-same-day">Include AMA ground transportation from the Ship to the Airport (Same Day)</option>&#13;
			<option label="Include AMA Pre-Cruise ground transportation from the Airport to the Hotel (Hotel to Ship is complementary)" value="include-ama-precruise-ground-transportation-from-the-airport-to-the-hotel-hotel-to-ship-is-complementary">Include AMA Pre-Cruise ground transportation from the Airport to the Hotel (Hotel to Ship is complementary)</option>&#13;
		</field>&#13;
		<field type="textarea" label="Comments" name="comments" className="form-control"/>&#13;
	</fields>&#13;
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