<html> <body> <form-template> <fields> <field type="header" subtype="h3" label="We are excited to have you join us on our upcoming Virgin Voyages Takeover. We currently have 1 Solo Insider for $1,987.15 total for one sailor. Our Voyage is less than 30 days away so this offer won't last long. This offer is first come, first serve."/> <field type="paragraph" subtype="p" label="Please complete the following information to complete your reservation request. This voyage requires a passport or certified birth certificate with government-issued photo I.D. to travel. We have attached a credit card authorization form to submit payment details for the full voyage fare.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;"/> <field type="header" subtype="h1" label="Sailor 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="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="clientLoyaltyPrograms" label="Loyalty Programs" description="Please provide a cruise membership number for any applicable cruise line listed. This may qualify you for additional benefits." name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/> <field type="radio-group" required="true" label="Would you like to upgrade your room to a Sea Terrace cabin or Higher if available? You will receive an invoice for the cabin fare difference." name="would-you-like-to-upgrade-your-room-to-a-sea-terrace-cabin-or-higher-if-available-you-will-receive-an-invoice-for-the-cabin-fare-difference"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="If answered yes to the question above, please select your requested cabin upgrade type:" name="if-answered-yes-to-the-question-above-please-select-your-requested-cabin-upgrade-type"> <option label="Limited View Sea Terrace" value="limited-view-sea-terrace">Limited View Sea Terrace</option> <option label="Sea Terrace" value="sea-terrace">Sea Terrace</option> <option label="Central Sea Terrace" value="central-sea-terrace">Central Sea Terrace</option> <option label="Rock Star Suite" value="rock-star-suite">Rock Star Suite</option> </field> <field type="textarea" label="If your requested cabin type upgrade is available, please provide the name of any additional guests you would like on the reservation." name="please-provide-the-first-name-last-name-and-date-of-birth-for-the-additional-sailors-in-your-cabin" className="form-control"/> <field type="radio-group" required="true" label="Would you like your reservation to include our 4-star pre-cruise hotel accommodation &amp; port transportation with the group for $255.20?" name="would-you-like-your-reservation-to-include-our-4star-precruise-hotel-accommodation-port-transportation-with-the-group-for-25520"> <option label="Yes, count me in" value="yes-count-me-in">Yes, count me in</option> <option label="No, thank you" value="no-thank-you">No, thank you</option> </field> <field type="radio-group" label="Would you like to participate in the group ATV excursion for $100 per person?" name="would-you-like-to-participate-in-the-group-atv-excursion-for-100-per-person"> <option label="Yes, count me in" value="yes-count-me-in">Yes, count me in</option> <option label="No, thank you." value="no-thank-you">No, thank you.</option> </field> <field type="checkbox-group" required="true" label="I understand..." name="i-understand"> <option label="The final payment is required." value="the-final-payment-is-required">The final payment is required.</option> <option label="The final payment is non-refundable." value="the-final-payment-is-nonrefundable">The final payment is non-refundable.</option> <option label="If my requested room upgrade is available I will receive an updated invoice for the cruise fare difference." value="if-my-requested-room-upgrade-is-available-i-will-receive-an-updated-invoice-for-the-cruise-fare-difference">If my requested room upgrade is available I will receive an updated invoice for the cruise fare difference.</option> <option label="Any remaining balance due must be paid within 24 hours." value="any-remaining-balance-due-must-be-paid-within-24-hours">Any remaining balance due must be paid within 24 hours.</option> <option label="This is a reservation request with payment authorization. You will be contacted within 24 business hours if your reservation is confirmed." value="this-is-a-reservation-request-with-payment-authorization-you-will-be-contacted-within-24-business-hours-if-your-reservation-is-confirmed">This is a reservation request with payment authorization. You will be contacted within 24 business hours if your reservation is confirmed.</option> </field> </fields> </form-template> </body> </html>
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