Share your information with Heather Mirabito

Heather Mirabito

Cure Family Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Let&#39;s Start Planning your Disney Cruise!"/>&#13;
		<field type="paragraph" subtype="p" label="Hi! Thanks so much for reaching out! Please fill out the form below if you are ready to start the planning process for your next vacation."/>&#13;
		<field type="paragraph" subtype="p" label="Here&#39;s how it works:"/>&#13;
		<field type="paragraph" subtype="p" label="You fill out the form below"/>&#13;
		<field type="paragraph" subtype="p" label="I will send you some options based on the information you provide"/>&#13;
		<field type="paragraph" subtype="p" label="You choose which option is best"/>&#13;
		<field type="paragraph" subtype="p" label="I book it! (at no extra cost to you) "/>&#13;
		<field type="paragraph" subtype="p" label="You enjoy your vacation! "/>&#13;
		<field type="paragraph" subtype="p" label="I receive commission direct from the vendor after your travels are complete "/>&#13;
		<field type="paragraph" subtype="p" label="** Serious inquires only please. "/>&#13;
		<field type="paragraph" subtype="p" label="If you have any questions, please email me: TravelByHM@gmail.com"/>&#13;
		<field type="text" required="true" label="Lead Guest&#39;s First Name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Lead Guest&#39;s 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" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Lead Guest&#39;s Date of Birth" name="date-1768745903245" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="I&#39;m interested in the following ship(s):" name="checkbox-group-1768745578344">&#13;
			<option label="Disney Destiny" value="disney-destiny">Disney Destiny</option>&#13;
			<option label="Disney Treasure" value="disney-treasure">Disney Treasure</option>&#13;
			<option label="Disney Wish" value="disney-wish">Disney Wish</option>&#13;
			<option label="Disney Fantasy" value="disney-fantasy">Disney Fantasy</option>&#13;
			<option label="Disney Drean" value="disney-drean">Disney Drean</option>&#13;
			<option label="Disney Wonder" value="disney-wonder">Disney Wonder</option>&#13;
			<option label="Disney Magic" value="disney-magic">Disney Magic</option>&#13;
			<option label="I'm not sure, I need some help deciding" value="im-not-sure-i-need-some-help-deciding">I'm not sure, I need some help deciding</option>&#13;
		</field>&#13;
		<field type="text" label="Preferred Departure Port" name="text-1768745770484" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Departure Date" name="date-1768745788488" className="form-control"/>&#13;
		<field type="date" label="Return Date" name="date-1768745795501" className="form-control"/>&#13;
		<field type="text" label="How many adults are traveling?" name="text-1768746076283" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many children are traveling?" name="text-1768754827046" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please list full names and date of birth for all other travelers&amp;nbsp;" description="This information is required to create your reservation and secure the booking." name="textarea-1768754678562" className="form-control"/>&#13;
		<field type="select" required="true" label="Preferred Stateroom Category:" name="select-1768745884938" className="form-control">&#13;
			<option label="Inside (no windows)" value="inside-no-windows">Inside (no windows)</option>&#13;
			<option label="Oceanview (window or porthole)" value="oceanview-window-or-porthole">Oceanview (window or porthole)</option>&#13;
			<option label="Verandah (balcony)" value="verandah-balcony">Verandah (balcony)</option>&#13;
			<option label="Concierge (exclusive perks)" value="concierge-exclusive-perks">Concierge (exclusive perks)</option>&#13;
			<option label="I need help deciding" value="i-need-help-deciding">I need help deciding</option>&#13;
		</field>&#13;
		<field type="text" label="Preferred Deck:" name="text-1768746290438" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are you a member of any of the following:" name="checkbox-group-1768747696534">&#13;
			<option label="Disney Castaway Club" value="disney-castaway-club">Disney Castaway Club</option>&#13;
			<option label="Disney Vacation Club (DVC)" value="disney-vacation-club-dvc">Disney Vacation Club (DVC)</option>&#13;
			<option label="Adventures by Disney Insider" value="adventures-by-disney-insider">Adventures by Disney Insider</option>&#13;
			<option label="Golden Oak" value="golden-oak">Golden Oak</option>&#13;
			<option label="Club 33" value="club-33">Club 33</option>&#13;
			<option label="No I am not/ I'm not sure" value="no-i-am-not-im-not-sure">No I am not/ I'm not sure</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like to add the Vacation Protection Plan through Disney Cruise Line?" name="select-1768747008181" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I would like more information on the Vacation Protection Plan" value="i-would-like-more-information-on-the-vacation-protection-plan">I would like more information on the Vacation Protection Plan</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like to add prepaid gratuities?&amp;nbsp; Disney Cruise Line offers the option to prepay onboard gratuities. I always recommend adding them, as it allows you to lock in the cost ahead of time and enjoy a truly stress-free experience onboard without having to worry about additional charges at the end of your cruise.&amp;nbsp;" name="select-1768747532540" className="form-control">&#13;
			<option label="Yes, please include prepaid gratuities" value="yes-please-include-prepaid-gratuities">Yes, please include prepaid gratuities</option>&#13;
			<option label="No, I prefer to handle gratuities onboard and understand these must be paid prior to disembarkation" value="no-i-prefer-to-handle-gratuities-onboard-and-understand-these-must-be-paid-prior-to-disembarkation">No, I prefer to handle gratuities onboard and understand these must be paid prior to disembarkation</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Are you interested in a pre or post cruise hotel stay?" name="checkbox-group-1768749726116">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No, thank you!" value="no-thank-you">No, thank you!</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Passport Confirmation: I understand that passports are highly recommended for cruise travel and are required for one-way and international cruises on Disney Cruise Line&amp;nbsp;" name="checkbox-group-1768749088097">&#13;
			<option label="I confirm that all travelers listed have valid passports" value="i-confirm-that-all-travelers-listed-have-valid-passports">I confirm that all travelers listed have valid passports</option>&#13;
			<option label="I do not yet have passports for all travelers but am in the process of obtaining them " value="i-do-not-yet-have-passports-for-all-travelers-but-am-in-the-process-of-obtaining-them-">I do not yet have passports for all travelers but am in the process of obtaining them </option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I acknowledge and understand that Disney Cruise Line prohibits guests from sailing if there are 24 weeks pregnant or more at the time of embarkation, or if they will reach 24 weeks of pregnancy during the cruise" name="checkbox-group-1768747807694">&#13;
			<option label="I confirm that I understand and will comply with this policy" value="i-confirm-that-i-understand-and-will-comply-with-this-policy">I confirm that I understand and will comply with this policy</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="The United States Public Health Service requires that only children who are toilet trained are permitted to enter aboard cruise ships. Children who are not toilet trained are welcome to enjoy the kids&#39;s wet play areas and splash zones, where they must wear swim diapers.&amp;nbsp; Swim diapers are not allowed in the pools, hot tubs or spas, the AquaDuck and the AquaLab." name="checkbox-group-1768753133142">&#13;
			<option label="I understand and acknowledge this policy" value="i-understand-and-acknowledge-this-policy" selected="selected">I understand and acknowledge this policy</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="To make sure I can give your vacation the time and attention it deserves, I ask that clients work with me exclusively for planning once a quote is requested. Since pricing is set directly by Disney Cruise Line, pricing will be the same regardless of which agent you book with. Because of this, I do not compete with other agents and I ask that all planning and quote requests for this trip be handled through me.&amp;nbsp; I appreciate your understanding and support!" name="radio-group-1768747959386">&#13;
			<option label="I am not currently working with another travel agent " value="i-am-not-currently-working-with-another-travel-agent-">I am not currently working with another travel agent </option>&#13;
			<option label="I previously contacted another agent but am no longer working with them and would like you to assist" value="i-previously-contacted-another-agent-but-am-no-longer-working-with-them-and-would-like-you-to-assist">I previously contacted another agent but am no longer working with them and would like you to assist</option>&#13;
		</field>&#13;
		<field type="text" label="Anything else you would like me to know? Celebrating a special occasion, must haves, accessibility needs, etc.&amp;nbsp;" name="text-1768748622019" subtype="text" className="form-control"/>&#13;
		<field type="text" label="I would love to connect with you on social media. If you have an Instagram account, please share your handle below or follow me @your.greatest.adventure&amp;nbsp;" name="text-1768748885439" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If a friend or family member referred you, please let me know!" name="text-1768748837922" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>