<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="🛳️ Sail With Christina — Cruise Quote Request Form"/> <field type="checkbox-group" label="Select your sailing below to receive current pricing and availability." name="checkbox-group-1787191739071"> <option label="Norwegian Dawn — MLK Weekend Bahamas Getaway January 15–19, 2027 | 4-Day Bahamas | Jacksonville" value="norwegian-dawn-mlk-weekend-bahamas-getaway-january-1519-2027-4day-bahamas-jacksonville">Norwegian Dawn — MLK Weekend Bahamas Getaway January 15–19, 2027 | 4-Day Bahamas | Jacksonville</option> <option label="Carnival Festivale — U.S. Inaugural Sailing May 19 - 23, 2027" value="carnival-festivale-us-inaugural-sailing-may-19-23-2027">Carnival Festivale — U.S. Inaugural Sailing May 19 - 23, 2027</option> <option label="Carnival Legend — Alaska Adventure June 22–29, 2027 | 7-Day Alaska | Seattle" value="carnival-legend-alaska-adventure-june-2229-2027-7day-alaska-seattle">Carnival Legend — Alaska Adventure June 22–29, 2027 | 7-Day Alaska | Seattle</option> </field> <field type="checkbox-group" required="true" label="Stateroom Cabin Type" name="checkbox-group-1787195953827"> <option label="Interior (No Windows)" value="interior-no-windows">Interior (No Windows)</option> <option label="Ocean View (Window)" value="ocean-view-window">Ocean View (Window)</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> </field> <field type="radio-group" required="true" label="Do you need an Accessible Cabin?" name="radio-group-1787194533332"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Primary Cruiser Information"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" description="Please include Suffix if applicable." name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="State of Residence" name="address-state" subtype="text" className="form-control"/> <field type="date" required="true" label="Birthday" name="date-1787109359816" className="form-control"/> <field type="clientLoyaltyPrograms" label="Cruise Line Loyalty/Rewards Number (If Applicable)" description="Don't know your loyalty number? I may be able to assist with looking it up." 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) ***" className="form-control"/> <field type="radio-group" label="Qualify for a special rate?" description="Special Rates may vary per cruise line guidelines." name="radio-group-1787193706255"> <option label="Military" value="military">Military</option> <option label="First Responder" value="first-responder">First Responder</option> <option label="Education Professional (K–12 & Higher Education)" value="education-professional-k12-higher-education">Education Professional (K–12 & Higher Education)</option> </field> <field type="header" subtype="h1" label="Who's Sailing With You?"/> <field type="select" required="true" label="How many guests will be in your stateroom?" name="select-1787192680417" className="form-control"> <option label="1 - Solo Traveler" value="1-solo-traveler">1 - Solo Traveler</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> </field> <field type="radio-group" required="true" label="Will you need more than one stateroom?" name="radio-group-1787192815377"> <option label="Yes" value="yes">Yes</option> <option label="Yes (Connecting Rooms)" value="yes-connecting-rooms">Yes (Connecting Rooms)</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Additional Cruiser(s) Information"/> <field type="textarea" label="Cruiser #2 (Full Name, Date of Birth, State of Residence &amp; Cruise Line Loyalty Number (if applicable)" placeholder="Jane Smith | 01/15/1980 | NC | Cruise Line #123456789" name="textarea-1787194150780" className="form-control"/> <field type="textarea" label="Cruiser #3 (Full Name, Date of Birth, State of Residence &amp; Cruise Line Loyalty Number (if applicable)" placeholder="Jane Smith | 01/15/1980 | NC | Cruise Line #123456789" name="textarea-1787194444971" className="form-control"/> <field type="textarea" label="Cruiser #4 (Full Name, Date of Birth, State of Residence &amp; Cruise Line Loyalty Number (if applicable)" placeholder="Jane Smith | 01/15/1980 | NC | Cruise Line #123456789" name="textarea-1787194446739" className="form-control"/> <field type="textarea" label="Cruiser #5 (Full Name, Date of Birth, State of Residence &amp; Cruise Line Loyalty Number (if applicable)" placeholder="Jane Smith | 01/15/1980 | NC | Cruise Line #123456789" name="textarea-1787194476147" className="form-control"/> <field type="header" subtype="h1" label="Additional Information"/> <field type="radio-group" required="true" label="When will you be deposit ready?" name="radio-group-1787194989648"> <option label="Ready Now" value="ready-now">Ready Now</option> <option label="Within 7 Days" value="within-7-days">Within 7 Days</option> <option label="Within 30 Days" value="within-30-days">Within 30 Days</option> <option label="I'm researching right now." value="im-researching-right-now">I'm researching right now.</option> </field> <field type="textarea" label="Is there anything else you'd like me to know?" placeholder="Celebrating something special? Have a cabin preference accessibility need questions, or other information that may help me prepare your quote? Let me know here." name="textarea-1787195178032" className="form-control"/> <field type="header" subtype="h2" label="BEFORE YOU SUBMIT"/> <field type="paragraph" subtype="p" label="Submitting this form is a request for a quote and does not create or hold a reservation. Cruise fares, promotions, deposits, and cabin availability are subject to change until a reservation is confirmed with the required deposit."/> <field type="paragraph" subtype="p" label="To participate in the Sail With Christina experience, your cruise must be booked through Oceanic Bliss Travel Agency. This ensures you're included in group communications, optional meet-ups, dining arrangements, and any special gifts or perks associated with your sailing."/> </fields> </form-template> </body> </html>
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