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EA Varga

Varga Vacations with Pixie Travel

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Name &amp;amp; Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-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="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many people are going on this trip?" name="how-many-people-are-going-on-this-trip" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are children going on this trip?" description="Under 18" name="radio-group-1768930626479">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768930681116" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzY4OTMwNjI2NDc5Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJwbGVhc2UtbGlzdC10aGUtY2hpbGRyZW5zLWFnZXMiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwbGVhc2UtbGlzdC10aGUtY2hpbGRyZW5zLWFnZXMiLCJsYWJlbCI6IlBsZWFzZSBsaXN0IHRoZSBjaGlsZHJlbidzIGFnZXMgYXQgdGltZSBvZiB0cmlwLiJ9XX0="/>&#13;
		<field type="text" label="Please list the children&#39;s ages at time of trip." name="please-list-the-childrens-ages" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="textarea" label="If you would like more than one stateroom, please list how you would like the rooms divided" name="if-you-would-like-more-than-one-stateroom-please-list-how-you-would-like-the-rooms-divided" className="form-control"/>&#13;
		<field type="pageBreak" name="pageBreak-1771466778939" next="Next" previous="Previous"/>&#13;
		<field type="textarea" required="true" label="When would you like to sail?" description="*Now Booking Through May 2027*" name="when-would-you-like-to-sail" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How many nights would you like to sail?" description="Please select all that apply" name="checkbox-group-1771467057811">&#13;
			<option label="3 nights" value="3-nights">3 nights</option>&#13;
			<option label="4 nights" value="4-nights">4 nights</option>&#13;
			<option label="5 nights" value="5-nights">5 nights</option>&#13;
			<option label="7 nights" value="7-nights">7 nights</option>&#13;
			<option label="8+ nights" value="8-nights">8+ nights</option>&#13;
			<option label="Unsure; talk more through this" value="unsure-talk-more-through-this">Unsure; talk more through this</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Where would you like to sail?" description="Please select all that apply" name="checkbox-group-1771467106447">&#13;
			<option label="Alaska" value="alaska">Alaska</option>&#13;
			<option label="Bahamas" value="bahamas">Bahamas</option>&#13;
			<option label="Caribbean" value="caribbean">Caribbean</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Unsure; talk more through this" value="unsure-talk-more-through-this">Unsure; talk more through this</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like your sailing to include a stop at one of Disney&#39;s Island Retreats?" description="Please note this is not applicable for Alaska or Europe cruises" name="radio-group-1771467153548">&#13;
			<option label="Yes, Castaway Cay" value="yes-castaway-cay">Yes, Castaway Cay</option>&#13;
			<option label="Yes, Lookout Cay" value="yes-lookout-cay">Yes, Lookout Cay</option>&#13;
			<option label="Yes, either Lookout or Castaway" value="yes-either-lookout-or-castaway">Yes, either Lookout or Castaway</option>&#13;
			<option label="Yes, BOTH Lookout AND Castaway" value="yes-both-lookout-and-castaway">Yes, BOTH Lookout AND Castaway</option>&#13;
			<option label="It doesn't matter" value="it-doesnt-matter">It doesn't matter</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Is this your first Disney Cruise?" name="radio-group-1771467211973">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1771467284138" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzcxNDY3MjExOTczIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6Im5vIiwidGhlbkFjdGlvbiI6InNob3ciLCJ0aGVuRmllbGRzIjpbInRleHQtMTc3MTQ2NzIyNzY5MiJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InRleHQtMTc3MTQ2NzIyNzY5MiIsImxhYmVsIjoiSWYgeW91J3ZlIHNhaWxlZCBiZWZvcmUsIHBsZWFzZSBsaXN0IHlvdXIgQ2FzdGF3YXkgQ2x1YiBTdGF0dXMgYW5kIENhc3Rhd2F5IENsdWIgTnVtYmVyIn1dfQ=="/>&#13;
		<field type="text" label="Please list your Castaway Club Status and Castaway Club Number" name="text-1771467227692" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="radio-group" label="Are you a Disney Visa Cardholder?" name="radio-group-1771467239003">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Is there anything else you&#39;d like to tell me about this vacation? Any special needs or concerns? Any special celebrations?" name="is-there-anything-else-youd-like-to-tell-me-about-this-vacation-any-special-needs-or-concerns-any-special-celebrations" className="form-control"/>&#13;
		<field type="text" label="If someone referred you, please share their name here so that I may thank them!" name="text-1771466870640" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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