TravelJoy

Lisa Cohen-Dumani

The Travel Fairy

Away Babes Portugal Trip

Oct 6, 2022 to Oct 12, 2022

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		<field type="header" subtype="h2" label="Full name"/>
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>
		<field type="date" required="true" label="Birth Date" name="birth-date" className="form-control"/>
		<field type="text" required="true" label="Primary Phone Number" name="phone-number" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Address"/>
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Passport Info"/>
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>
		<field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>
		<field type="radio-group" label="Gender" name="gender">
			<option label="F" value="female">F</option>
			<option label="M" value="male">M</option>
		</field>
		<field type="radio-group" label="Can you commit to some early mornings?&amp;nbsp; And a few late nights?&amp;nbsp; Nothing too intense, but we do like to hit the ground running." name="can-you-commit-to-some-early-mornings-and-a-few-late-nights-nothing-too-intense-but-we-do-like-to-hit-the-ground-running">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="textarea" label="Why do you want to visit Costa Rica?" name="why-do-you-want-to-visit-portugal" className="form-control"/>
		<field type="textarea" label="What does stepping out of your comfort zone look like?" name="what-does-stepping-out-of-your-comfort-zone-look-like" className="form-control"/>
		<field type="textarea" label="Do you have any food allergies or dietary restrictions?" name="do-you-have-any-food-allergies-or-dietary-restrictions" className="form-control"/>
		<field type="textarea" label="Do you have any injuries or physical disabilities that would hinder your ability to walk a couple of miles at a time on uneven surfaces, like cobblestones?&amp;nbsp; Nothing crazy, but we are going to be on the move.&amp;nbsp; If so, please explain." name="do-you-have-any-injuries-or-physical-disabilities-that-would-hinder-your-ability-to-walk-a-couple-of-miles-at-a-time-on-uneven-surfaces-like-cobblestones-nothing-crazy-but-we-are-going-to-be-on-the-move-if-so-please-explain" className="form-control"/>
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