<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="2024 Bordeaux River Cruise with Neal Wavra (June 23 - June 30, 2024)"/> <field type="paragraph" subtype="p" label="Thank you for your interest.&nbsp; We are taking registrations on a first come, first serve basis.&nbsp; Please complete your information and preferences below.&nbsp; We will assign categories on a first come, first serve basis.&nbsp; Your cruise deposit and service fee will not be charged until your booking is confirmed through us.&nbsp; Once you are confirmed and your security deposit/fees are paid, we will begin your individual planning process for the trip (air, ground, additional requests).&nbsp;"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="date" required="true" label="Your Date of Birth" name="your-date-of-birth" className="form-control"/> <field type="header" subtype="h1" label="Deposit and Fees"/> <field type="paragraph" subtype="p" label="Non-Refundable Cruise Deposit of ten percent of your total discounted cruise fare plus port plus tax fees of $220.00 per person. The security deposit will be processed once within three days.&nbsp; If we are unable to provide you with your cabin category request we will let you know what is available and only proceed with your deposit if you approve.&nbsp;"/> <field type="paragraph" subtype="p" label="Professional Service and Management Fee of $150.00 per passenger, non-refundable fee to coordinate and manage your travel program, including air, land accommodations, additional itinerary requests, and travel insurance.&nbsp; You will receive a separate invoice for these charges.&nbsp;"/> <field type="header" subtype="h1" label="Number of Passengers&nbsp;"/> <field type="radio-group" required="true" label="Number of passengers traveling including me" name="number-of-passengers-traveling-including-me"> <option label="1 (Just me - single occupancy)" value="1-just-me-single-occupancy">1 (Just me - single occupancy)</option> <option label="2 (Me and one other passenger - same cabin)" value="2-me-and-one-other-passenger-same-cabin">2 (Me and one other passenger - same cabin)</option> </field> <field type="header" subtype="h1" label="Additional Passenger Information"/> <field type="text" label="Additional Passenger First and Last name" name="additional-passenger-first-and-last-name" subtype="text" className="form-control"/> <field type="text" label="Additional Passenger Email" name="additional-passenger-email" subtype="text" className="form-control"/> <field type="date" label="Additional Passenger Date of Birth" name="additional-passenger-date-of-birth" className="form-control"/> <field type="header" subtype="h1" label="Category and Fare Preference"/> <field type="radio-group" required="true" label="Per Person Pricing&nbsp; - please indicate your first preference" name="radio-group-1701373257249"> <option label="SOLD OUT $3,699.00 - Classic (double occupancy)" value="sold-out-369900-classic-double-occupancy">SOLD OUT $3,699.00 - Classic (double occupancy)</option> <option label="SOLD OUT $5,699.00 - Classic (single occupancy)" value="sold-out-569900-classic-single-occupancy">SOLD OUT $5,699.00 - Classic (single occupancy)</option> <option label="$4,399.00 - Deluxe (double occupancy)" value="439900-deluxe-double-occupancy">$4,399.00 - Deluxe (double occupancy)</option> <option label="$6,749.00 - Deluxe (single occupancy)" value="674900-deluxe-single-occupancy">$6,749.00 - Deluxe (single occupancy)</option> <option label="SOLD OUT $5,299.00 - French Balcony (double occupancy)" value="sold-out-529900-french-balcony-double-occupancy">SOLD OUT $5,299.00 - French Balcony (double occupancy)</option> <option label="SOLD OUT $8,099.00 - French Balcony (single occupancy)" value="sold-out-809900-french-balcony-single-occupancy">SOLD OUT $8,099.00 - French Balcony (single occupancy)</option> <option label="SOLD OUT $10,299.00 - Grand Suite (double occupancy)" value="sold-out-1029900-grand-suite-double-occupancy">SOLD OUT $10,299.00 - Grand Suite (double occupancy)</option> <option label="SOLD OUT $20,898.00 - Grand Suite (single occupancy)" value="sold-out-2089800-grand-suite-single-occupancy">SOLD OUT $20,898.00 - Grand Suite (single occupancy)</option> </field> <field type="header" subtype="h1" label="Day 7 Pessac/Leognan Exclusive Excursion with Neal Wavra"/> <field type="radio-group" required="true" label="I am interested in reserving a spot (details and pricing will be emailed separately)" name="i-am-interested-in-reserving-a-spot-details-and-pricing-will-be-emailed-separately"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Additional Travel Interests"/> <field type="radio-group" required="true" label="I am interested in additional pre and post cruise options, including extended land itineraries." name="i-am-interested-in-additional-pre-and-post-cruise-options-including-extended-land-itineraries"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Maybe" value="maybe">Maybe</option> </field> <field type="header" subtype="h1" label="Additional Information"/> <field type="textarea" label="Please provide any additional information you would like us to know at this time.&nbsp;" name="please-provide-any-additional-information-you-would-like-us-to-know-at-this-time-" className="form-control"/> </fields> </form-template> </body> </html>
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