Jennifer Robbins

Cruising Chicks

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		<field type="header" subtype="h2" label="Full name"/>&#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 required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Let's Find the best CRUISE!"/>&#13;
		<field type="checkbox-group" label="Is this your first cruise?" name="is-this-your-first-cruise">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
			<option label="I'm a cruise PRO!" value="im-a-cruise-pro">I'm a cruise PRO!</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Purpose of this cruise vacation is:" name="purpose-of-this-cruise-vacation-is">&#13;
			<option label="Making Memories w/ Family or Friends" value="making-memories-w-family-or-friends">Making Memories w/ Family or Friends</option>&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Just for FUN!" value="just-for-fun">Just for FUN!</option>&#13;
			<option label="Relax &amp; Recharge (SPA)" value="relax-recharge-spa">Relax &amp; Recharge (SPA)</option>&#13;
			<option label="Special Occasion" value="special-occasion">Special Occasion</option>&#13;
		</field>&#13;
		<field type="text" label="Where would you like to go? Tropical, Europe, or a certain port you must visit." description="b" name="where-would-you-like-to-go-tropical-europe-or-a-certain-port-you-must-visit" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are there ports you want to avoid?" name="are-there-ports-you-want-to-avoid" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Which cruise port would you like to depart from?" name="which-cruise-port-would-you-like-to-depart-from" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Which cruise line have you sailed with before?" name="which-cruise-line-have-you-sailed-with-before" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Which ones are on your Wishlist?" name="which-ones-are-on-your-wishlist" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What type of cabin are you interested in?" name="what-type-of-cabin-are-you-interested-in" other="true">&#13;
			<option label="We're splurging on a suite!" value="were-splurging-on-a-suite">We're splurging on a suite!</option>&#13;
			<option label="We like a balcony to enjoy morning coffee in the fresh, sea air an" value="we-like-a-balcony-to-enjoy-morning-coffee-in-the-fresh-sea-air-an">We like a balcony to enjoy morning coffee in the fresh, sea air an</option>&#13;
			<option label="As long as we have a window to look out, I'm happy" value="as-long-as-we-have-a-window-to-look-out-im-happy">As long as we have a window to look out, I'm happy</option>&#13;
			<option label="An interior cabin is where I get the best sleep" value="an-interior-cabin-is-where-i-get-the-best-sleep">An interior cabin is where I get the best sleep</option>&#13;
		</field>&#13;
		<field type="text" label="Would you call yourself a foodie? What type of food excites you?" name="would-you-call-yourself-a-foodie-what-type-of-food-excites-you" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are you looking forward to:" description="b" name="are-you-looking-forward-to">&#13;
			<option label="Buffet" value="buffet">Buffet</option>&#13;
			<option label="Main Dining room" value="main-dining-room">Main Dining room</option>&#13;
			<option label="Specialty restaurants" value="specialty-restaurants">Specialty restaurants</option>&#13;
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		<field type="select" label="Are any of these important?" name="are-any-of-these-important" multiple="multiple" className="form-control">&#13;
			<option label="Casino" value="casino">Casino</option>&#13;
			<option label="Babysitting" value="babysitting">Babysitting</option>&#13;
			<option label="Kids/Teen club" value="kidsteen-club">Kids/Teen club</option>&#13;
			<option label="Sports Court" value="sports-court">Sports Court</option>&#13;
			<option label="Water slides" value="water-slides">Water slides</option>&#13;
			<option label="Adults only pool area" value="adults-only-pool-area">Adults only pool area</option>&#13;
			<option label="Spa" value="spa">Spa</option>&#13;
			<option label="Outdoor movies" value="outdoor-movies">Outdoor movies</option>&#13;
			<option label="Nightly shows" value="nightly-shows">Nightly shows</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="b" name="what-kind-of-vibe-are-you-looking-for" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest &amp; relaxation" value="rest-relaxation">Rest &amp; relaxation</option>&#13;
			<option label="24 hour party " value="24-hour-party-">24 hour party </option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
			<option label="Food &amp; wine" value="food-wine">Food &amp; wine</option>&#13;
			<option label="Local Culture" value="local-culture">Local Culture</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="b" name="what-activities-are-you-interested-in" other="true">&#13;
			<option label="Beach &amp; water" value="beach-water">Beach &amp; water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure &amp; activities" value="adventure-activities">Adventure &amp; activities</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts &amp; Theater" value="arts-theater">Arts &amp; Theater</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What best describes your hotel/cruise preference?" name="what-best-describes-your-hotelcruise-preference" other="true">&#13;
			<option label="Value" value="value">Value</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is the price range you are comfortable with? Please specify if it is per person or total." name="what-is-the-price-range-you-are-comfortable-with-please-specify-if-it-is-per-person-or-total" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Practical Information"/>&#13;
		<field type="date" label="Earliest you can depart?" description="b" name="earliest-you-can-depart" className="form-control"/>&#13;
		<field type="date" label="Latest you can return?" description="b" name="latest-you-can-return" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="YES" value="yes">YES</option>&#13;
		</field>&#13;
		<field type="text" label="How many nights would you like to to cruise (can be a range) ?" name="how-many-nights-would-you-like-to-to-cruise-can-be-a-range-" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Number of cabins &amp;amp; location preferences- Do you need connected,&amp;nbsp; side-by-side&amp;nbsp; or just nearby okay?" name="number-of-cabins-location-preferences-do-you-need-connected-sidebyside-or-just-nearby-okay" className="form-control"/>&#13;
		<field type="textarea" label="Number of travelers and ages" name="number-of-travelers-and-ages" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?" name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Is everyone in your party a US citizen?" description="b" name="is-everyone-in-your-party-a-us-citizen" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Promotions you qualify for (if available)" name="promotions-you-qualify-for-if-available" other="true">&#13;
			<option label="Senior (55 or older)" value="senior-55-or-older">Senior (55 or older)</option>&#13;
			<option label="Military (active or retired)" value="military-active-or-retired">Military (active or retired)</option>&#13;
			<option label="Fire/EMS/Law  Enforcement" value="fireemslaw-enforcement">Fire/EMS/Law  Enforcement</option>&#13;
			<option label="Teacher" value="teacher">Teacher</option>&#13;
		</field>&#13;
		<field type="text" label="What state do you live in?" name="what-state-do-you-live-in" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is there anything you absolutely must do or see?" name="is-there-anything-you-absolutely-must-do-or-see" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Will you be using an AMEX card (for extra perks)" name="will-you-be-using-an-amex-card-for-extra-perks">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know? (dietary, medical or special requests, etc)" name="what-else-would-you-like-me-to-know-dietary-medical-or-special-requests-etc" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="I have requested that Just 2 Getaway Travel (Agency) make one or more travel bookings on my behalf.&amp;nbsp; As the worldwide COVID-19 pandemic remains ongoing at this time, I acknowledge that for this reason, and other reasons not reasonably for seeable at this time, these travel plans may be interrupted or canceled but the supplier that is providing them, a government entity or other third-party over which Agency has no control. I further acknowledge that the supplier's own cancellation, rebooking, and refund policies, subject to any applicable law that is now or may later be in effect, will govern my rights and remedies, including my right to receive a refund, in such an event. Moreover, I understand that should I elect to purchase travel insurance, the terms of the policy will dictate whether, and to what extent, coverage for any financial loss may exist under the circumstances. By signing below, I hereby agree to hold Agency harmless and release it from any and all liability for any damages, including but not limited to monetary losses, I may incur as a result of such interruption or cancellation of these travel plans. The bulk of our business is conducted via the use of credit or debit cards including MasterCard, Visa, Discover, and American Express. You are required to provide authorization to apply funds to arrangements in your name for every transaction for your trip. Your authorization, be it the full formal authorization or the shortened text version of authorization is a binding agreement for us to charge your card and as such, you waive any right to chargeback in the case of cancellation for any cause (except fraud), including a force majeure event, and agree to the refund policies dictated by the travel supplier. In the event a client attempts to chargeback, reverse, or recollect a payment already made without our express written consent, we reserve the right to collect all additional costs, fees, and expenses associated with such chargeback, reversal or recollection including, without limitation, attorney fees and Agency's rate of $50.00 per hour. The current travel environment is changing rapidly. Agency has provided you with the latest information at their disposal regarding the policies related to destination entry requirements as well as policies related to each travel component booked through Agency. You agree to hold harmless Agency if any changes occur between notice given and time of travel. Agency recommends every passenger register with the www.travel.us.gov/STEP program. It is your responsibility to register independently as this is a government locator program designed to track US travelers abroad. It is also your responsibility to monitor recommendations from sources such as the Center for Disease Control and the World Healthe Organization and make an informed decision regarding your travel plans. The current pandemic may limit the services and amenities available in your destination. Experiences and activities may be limited or unavailable. Dining and beverage options may also be limited at the hotel, resort, or cruise line's discretion. By signing this you understand that these limitations are outside Agency's control and does not release you from payment terms and conditions as dictated by the travel suppliers."/>&#13;
		<field type="checkbox-group" required="true" label="Please check one" name="please-check-one">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
			<option label="I disagree" value="i-disagree">I disagree</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Please share how you found us ( or who referred you, so we can thank them)." name="please-share-how-you-found-us-or-who-referred-you-so-we-can-thank-them" subtype="text" className="form-control"/>&#13;
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