Share your information with Racquel Nicholson

Racquel Nicholson

Laugh Travel & Live LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Laugh Travel Live — St. Augustine Bus Trip Interest Form"/>&#13;
		<field type="paragraph" subtype="p" label="We’re planning an exciting overnight getaway from Palm Beach to St. Augustine and would love your feedback before we officially launch the trip!"/>&#13;
		<field type="paragraph" subtype="p" label="Package Includes:
* Roundtrip bus transportation from Palm Beach
* 1-night hotel accommodations
* Day excursion &amp;amp; sightseeing
* Free time to explore St. Augustine"/>&#13;
		<field type="header" subtype="h3" label="Traveler Information"/>&#13;
		<field required="true"  type="text" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" subtype="email" label="Email Address" name="email" className="form-control"/>&#13;
		<field type="text" subtype="tel" label="Phone Number" name="phone-number" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred Travel Weekend" name="preferred-travel-weekend" className="radio-group">&#13;
			<option label="June 6-7, 2026" value="june-6-7-2026">June 6-7, 2026</option>&#13;
			<option label="June 20-21, 2026" value="june-20-21-2026">June 20-21, 2026</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Occupancy Preference" name="occupancy-preference" className="radio-group">&#13;
			<option label="Double Occupancy" value="double-occupancy">Double Occupancy</option>&#13;
			<option label="Single Occupancy" value="single-occupancy">Single Occupancy</option>&#13;
		</field>&#13;
		<field type="text" label="Who Are You Traveling With?" description="(Optional)" name="who-are-you-traveling-with" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Would You Like To Receive Booking Details Once The Trip Launches?" name="receive-booking-details" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Additional Comments or Questions" name="additional-comments-or-questions" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for your interest in traveling with Laugh Travel Live!
www.laughtravellive.com"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>