<form-template>
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field>
		<field type="date" label="Charlotte's Birthday Celebration - April 30, 2022&amp;nbsp;" description="Select Departure Date" name="charlottes-birthday-celebration-april-30-2022-" className="form-control"/>
		<field type="select" required="true" label="Jr. Suite Garden View" description="Please Select Room Category Prices are per person" placeholder="Please Select Room Category Prices" name="jr-suite-garden-view" className="form-control">
			<option label="3  nights: Single - $1003.79" value="3-nights-single-100379">3  nights: Single - $1003.79</option>
			<option label="3  nights: Double - $710.56" value="3-nights-double-71056">3  nights: Double - $710.56</option>
			<option label="3  nights:: Triple - $677.99" value="3-nights-triple-67799">3  nights:: Triple - $677.99</option>
			<option label="3  nights:: Child 2-12 - $366.38" value="3-nights-child-212-36638">3  nights:: Child 2-12 - $366.38</option>
			<option label="4 nights: Single - $1239.35" value="4-nights-single-123935">4 nights: Single - $1239.35</option>
			<option label="4 nights: Double - $873.02" value="4-nights-double-87302">4 nights: Double - $873.02</option>
			<option label="4 nights: Triple - $832.33" value="4-nights-triple-83233">4 nights: Triple - $832.33</option>
			<option label="4 nights: Child 2-12 - $443.02" value="4-nights-child-212-44302">4 nights: Child 2-12 - $443.02</option>
			<option label="5 nights: Single - $1474.92" value="5-nights-single-147492">5 nights: Single - $1474.92</option>
			<option label="5 nights: Double - $1035.48" value="5-nights-double-103548">5 nights: Double - $1035.48</option>
			<option label="5 nights: Triple - $986.66" value="5-nights-triple-98666">5 nights: Triple - $986.66</option>
			<option label="5 nights: Child 2-12 - $519.67" value="5-nights-child-212-51967">5 nights: Child 2-12 - $519.67</option>
			<option label="7 nights: Single - $1946.05" value="7-nights-single-194605">7 nights: Single - $1946.05</option>
			<option label="7 nights: Double - $1360.39" value="7-nights-double-136039">7 nights: Double - $1360.39</option>
			<option label="7 nights: Triple - $1295.33" value="7-nights-triple-129533">7 nights: Triple - $1295.33</option>
			<option label="7 nights: Child 2-12 - $672.96" value="7-nights-child-212-67296">7 nights: Child 2-12 - $672.96</option>
			<option label="None" value="none" selected="true">None</option>
		</field>
		<field type="select" required="true" label="Jr Suite Ocean View" description="Please Select Room Category Prices are per person and includes All Inclusive hotel accommodations and roundtrip airport transfers to and from the resort." placeholder="Please Select Room Category Prices" name="jr-suite-ocean-view" className="form-control">
			<option label="3 nights: Single - $1059.83" value="3-nights-single-105983">3 nights: Single - $1059.83</option>
			<option label="3 nights: Double - $749.21" value="3-nights-double-74921">3 nights: Double - $749.21</option>
			<option label="3 nights: Triple - $714.70" value="3-nights-triple-71470">3 nights: Triple - $714.70</option>
			<option label="3 nights: Child 2-12 - $376.67" value="3-nights-child-212-37667">3 nights: Child 2-12 - $376.67</option>
			<option label="4 nights: Single - $1314.14" value="4-nights-single-131414">4 nights: Single - $1314.14</option>
			<option label="4 nights: Double - $924.59" value="4-nights-double-92459">4 nights: Double - $924.59</option>
			<option label="4 nights: Triple - $881.31" value="4-nights-triple-88131">4 nights: Triple - $881.31</option>
			<option label="4 nights: Child 2-12 - $457.39" value="4-nights-child-212-45739">4 nights: Child 2-12 - $457.39</option>
			<option label="5 nights: Single - $1568.45" value="5-nights-single-156845">5 nights: Single - $1568.45</option>
			<option label="5 nights: Double - $1099.98" value="5-nights-double-109998">5 nights: Double - $1099.98</option>
			<option label="5 nights: Triple - $1047.92" value="5-nights-triple-104792">5 nights: Triple - $1047.92</option>
			<option label="5 nights: Child 2-12 - $538.10" value="5-nights-child-212-53810">5 nights: Child 2-12 - $538.10</option>
			<option label="7 nights: Single - $2077.05" value="7-nights-single-207705">7 nights: Single - $2077.05</option>
			<option label="7 nights: Double - $1450.74" value="7-nights-double-145074">7 nights: Double - $1450.74</option>
			<option label="7 nights: Triple - $1381.14" value="7-nights-triple-138114">7 nights: Triple - $1381.14</option>
			<option label="7 nights: Child 2-12 - $699.54" value="7-nights-child-212-69954">7 nights: Child 2-12 - $699.54</option>
			<option label="NONE" value="none" selected="true">NONE</option>
		</field>
		<field type="select" required="true" label="Jr Suite Oceanfront" description="Please Select Room Category Prices are per person and includes All Inclusive hotel accommodations and roundtrip airport transfers to and from the resort." placeholder="Please Select Room Category Prices" name="jr-suite-oceanfront" className="form-control">
			<option label="3 nights: Single - $1116.47" value="3-nights-single-111647">3 nights: Single - $1116.47</option>
			<option label="3 nights: Double - $788.30" value="3-nights-double-78830">3 nights: Double - $788.30</option>
			<option label="3 nights: Triple - $751.83" value="3-nights-triple-75183">3 nights: Triple - $751.83</option>
			<option label="3 nights: Child 2-12 - $394.67" value="3-nights-child-212-39467">3 nights: Child 2-12 - $394.67</option>
			<option label="4 nights: Single - $1389.66" value="4-nights-single-138966">4 nights: Single - $1389.66</option>
			<option label="4 nights: Double - $976.70" value="4-nights-double-97670">4 nights: Double - $976.70</option>
			<option label="4 nights: Triple - $930.81" value="4-nights-triple-93081">4 nights: Triple - $930.81</option>
			<option label="4 nights: Child 2-12 - $481.38" value="4-nights-child-212-48138">4 nights: Child 2-12 - $481.38</option>
			<option label="5 nights: Single - $1662.84" value="5-nights-single-166284">5 nights: Single - $1662.84</option>
			<option label="5 nights: Double - $1165.09" value="5-nights-double-116509">5 nights: Double - $1165.09</option>
			<option label="5 nights: Triple - $1109.79" value="5-nights-triple-110979">5 nights: Triple - $1109.79</option>
			<option label="5 nights: Child 2-12 - $568.09" value="5-nights-child-212-56809">5 nights: Child 2-12 - $568.09</option>
			<option label="7 nights: Single - $2209.19" value="7-nights-single-220919">7 nights: Single - $2209.19</option>
			<option label="7 nights: Double - $1541.88" value="7-nights-double-154188">7 nights: Double - $1541.88</option>
			<option label="7 nights: Triple - $1467.75" value="7-nights-triple-146775">7 nights: Triple - $1467.75</option>
			<option label="7 nights: Child 2-12 - $741.51" value="7-nights-child-212-74151">7 nights: Child 2-12 - $741.51</option>
			<option label="NONE" value="none" selected="true">NONE</option>
		</field>
		<field type="select" required="true" label="Suite" description="Please Select Room Category Prices are per person and includes All Inclusive hotel accommodations and roundtrip airport transfers to and from the resort." placeholder="Please Select Room Category Prices" name="suite" className="form-control">
			<option label="3 nights: Single - $1267.55" value="3-nights-single-126755">3 nights: Single - $1267.55</option>
			<option label="3 nights: Double - $892.48" value="3-nights-double-89248">3 nights: Double - $892.48</option>
			<option label="4 nights: Single - $1591.09" value="4-nights-single-159109">4 nights: Single - $1591.09</option>
			<option label="4 nights: Double - $1115.60" value="4-nights-double-111560">4 nights: Double - $1115.60</option>
			<option label="5 nights: Single - $1914.63" value="5-nights-single-191463">5 nights: Single - $1914.63</option>
			<option label="5 nights: Double - $1338.73" value="5-nights-double-133873">5 nights: Double - $1338.73</option>
			<option label="7 nights: Single - $2561.71" value="7-nights-single-256171">7 nights: Single - $2561.71</option>
			<option label="7 nights: Double - $1784.98" value="7-nights-double-178498">7 nights: Double - $1784.98</option>
			<option label="NONE" value="none" selected="true">NONE</option>
		</field>
		<field type="radio-group" required="true" label="Do you need airfare?&amp;nbsp;" name="are-dates-flexible">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="text" required="true" label="If yes, from what gateway?&amp;nbsp;" name="departure-city" subtype="text" className="form-control"/>
		<field type="radio-group" required="true" label="Number of rooms&amp;nbsp;" name="number-of-rooms-">
			<option label="1" value="1">1</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" label="Number of Guests" name="number-of-guests">
			<option label="1" value="1">1</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="textarea" label="Guests" placeholder="Please provide the names and date of birth for all guests in your party as shown on their passport." name="guests" 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="Email Address" name="email" subtype="text" className="form-control"/>
		<field type="text" label="Address" name="address-line-1" subtype="text" className="form-control"/>
		<field type="text" label="Address 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="text" label="Country" name="address-country" subtype="text" className="form-control"/>
		<field type="radio-group" required="true" label="Best Method of Contact" name="best-method-of-contact">
			<option label="Phone" value="phone">Phone</option>
			<option label="Email" value="email">Email</option>
			<option label="Text" value="text">Text</option>
		</field>
		<field type="textarea" label="Travel Protection" description="Travel Protection Plus~ is a great way to take the worry out of travel. Travelers will receive the best pre-departure benefits in the industry that include our incredible Cancel For Any Reason&#x2020; feature. Add Travel Protection Plus to any group reservation within 7 days of booking. Please note for Contracted Groups the Travel Protection Plus plan pricing is not guaranteed at the time of signed group contract. Each booking choosing to purchase Travel Protection Plus within a contracted group is subject to the rate available at the time the individual bookings are made.  For More read this https://www.applevacations.com/travel-protection-plus/" placeholder="All Travel Protection Plans include: &#xF0B7; Cancel the vacation  for whatever reason  and you&#x2019;re covered - Cancel for ANY reason. Plus  no change fees and a hurricane travel credit. Non-refundable hotel rates are not included. &#xF0B7; Worry less about travel mishaps - Now up to $3000 in catch-up expenses if the trip is delayed 6 hours or more (previously the maximum was $500), up to $300 if bags are delayed, up to $1,000 for lost belongings, and up to $50,000 reimbursement of medical expenses if you get sick or hurt during your trip, plus up to $75,000 for emergency transportation. &#xF0B7; Wherever you are, Whenever you need it, We&#x2019;re always here to help - 24/7 travel assistance, medical assistance and emergency services. Travel Protection Options: &#xF0B7; Travel Protection Plus &#x2013; Cash Refund ($139.99 to $284.99* per adult) - this plan is for travelers who would want to receive a full refund in the original form of payment if plans change and need to cancel. &#xF0B7; Travel Protection Plus &#x2013; Full Travel Credit &#x2013; ($49.99 to $124.99* per adult) &#x2013; this plan is for budget-conscious travelers. Same great Travel Protection Plus coverage, just a lower price point. Perfect for those travelers who know they will travel, but need some flexibility. Notes: Adults are defined as 13 years and older at time of travel. Pricing for children 12 years and under varies based on Travel Protection Plan selected for the adults ($24.99 to $114.99). Travel Protection Plus in non-refundable once purchased and overrides the ALG contract terms for the protected traveler. Travel Protection Plus covers all air (Exclusive Nonstop Vacation Flights, Contracted Blocked Air, and Individual Scheduled Air Add On) when packaged with hotel. Travel Protection Plus is available to only those travelers within a reservation that want it; however, doesn&#x2019;t cover any increase in package costs due to changes in hotel occupancy. (~) Travel Protection Plus does not protect a group&#x2019;s scheduled air contract (inventory &amp; price) in the event the minimum requirement of 10 seats (or as specified on the group contract) is not met. New air prices may be issued by the airline and original airline cancellation penalties may apply. (&#x2020;) Less the cost of Travel Protection Plus. (*) Holiday surcharge December 18-30 per passenger: Add $30 for 13 years and older | Add $15 for 12 years and under (maximum $114.99)." name="travel-protection" className="form-control"/>
		<field type="radio-group" required="true" label="Please select an option below. (Rates are based on package cost)" name="please-select-an-option-below-rates-are-based-on-package-cost">
			<option label="Travel Protection Plus -full travel credit. ($49.99 to $124.99* per adult)" value="travel-protection-plus-full-travel-credit-4999-to-12499-per-adult">Travel Protection Plus -full travel credit. ($49.99 to $124.99* per adult)</option>
			<option label="Travel Protection Plus -cash refund ($139.99 to $284.99* per adult)" value="travel-protection-plus-cash-refund-13999-to-28499-per-adult">Travel Protection Plus -cash refund ($139.99 to $284.99* per adult)</option>
			<option label="Decline" value="decline">Decline</option>
		</field>
		<field type="text" required="true" label="Cancellation Policy" description="96+ days prior to departure: no penalty will apply. 95 - 66 days prior to departure: initial deposit will not be refundable. 65 - 51 days prior to departure: group will have 1 night penalty per room based on category. 50 - 36 days prior to departure: group will have 2 night penalty per room based on category. 35 - 0 days prior to departure: will apply 100% penalty for all rooms. All no shows  reductions and cancellations will be charged as single  double or triple occupancy in the room category canceled." placeholder="Please Type Your Name Here to Accept the above policy." name="cancellation-policy" subtype="text" className="form-control"/>
		<field type="checkbox-group" label="I have read and understand the policy outlined above." description="General/Cancellation Terms &amp; Conditions  https://www.applevacations.com/terms/" toggle="true" name="i-have-read-and-understand-the-policy-outlined-above">
			<option label="ACCEPT" value="accept" selected="true">ACCEPT</option>
		</field>
	</fields>
</form-template>