Share your information with Live In The Dash Travel Agency

Live In The Dash Travel Agency

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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 type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Cruise Preferences"/>&#13;
		<field type="select" label="Select" name="select-1768603053586" multiple="multiple" className="form-control">&#13;
			<option label="Virgin Voyages" value="virgin-voyages">Virgin Voyages</option>&#13;
			<option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option>&#13;
			<option label="Carnival" value="carnival">Carnival</option>&#13;
			<option label="Celebrity Cruise" value="celebrity-cruise">Celebrity Cruise</option>&#13;
			<option label="Norwegian Cruise " value="norwegian-cruise-">Norwegian Cruise </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Departure Port&amp;nbsp;" placeholder="Example: Miami  Port Canaveral  Galveston  Norfolk" name="text-1768603843839" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" required="true" label="Preferred Sail Date (Start)" name="date-1768604346963" className="form-control"/>&#13;
		<field type="date" required="true" label="Preferred Sail Date (End)" name="date-1768604537385" className="form-control"/>&#13;
		<field type="select" required="true" label="Cabin Type" name="select-1768604703295" multiple="multiple" className="form-control">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Not Sure " value="not-sure-">Not Sure </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Number of Adults" name="text-1768604873834" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Children" name="text-1768604950884" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Total Number of Travelers" placeholder="Example: 2" name="text-1768604993038" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Group Booking (5+ Travelers) If you are booking for 5 or more travelers, please complete the section below"/>&#13;
		<field type="header" subtype="h1" label="(5+ travelers) will receive a separate booking form and payment structure. A Live In The Dash Travel Specialist will contact the group primary contact within 24 hours." className="field-hidden"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770950078773" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiaGVhZGVyLTYiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJoZWFkZXItNiIsImxhYmVsIjoiKDUrIHRyYXZlbGVycykgd2lsbCByZWNlaXZlIGEgc2VwYXJhdGUgYm9va2luZyBmb3JtIGFuZCBwYXltZW50IHN0cnVjdHVyZS4gQSBMaXZlIEluIFRoZSBEYXNoIFRyYXZlbCBTcGVjaWFsaXN0IHdpbGwgY29udGFjdCB0aGUgZ3JvdXAgcHJpbWFyeSBjb250YWN0IHdpdGhpbiAyNCBob3Vycy4ifV19"/>&#13;
		<field type="radio-group" required="true" label="Is this a group booking (5+ travelers)?" name="is-this-a-group-booking-5-travelers">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Group Name (if applicable)" name="group-name-if-applicable" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770947835752" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiZ3JvdXAtbmFtZS1pZi1hcHBsaWNhYmxlIl0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoiZ3JvdXAtbmFtZS1pZi1hcHBsaWNhYmxlIiwibGFiZWwiOiJHcm91cCBOYW1lIChpZiBhcHBsaWNhYmxlKSJ9XX0="/>&#13;
		<field type="text" label="Special Occasion or Theme (Birthday, Wedding, Carnival, Takeover, etc.)" name="special-occasion-or-theme-birthday-wedding-carnival-takeover-etc" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770948448278" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsic3BlY2lhbC1vY2Nhc2lvbi1vci10aGVtZS1iaXJ0aGRheS13ZWRkaW5nLWNhcm5pdmFsLXRha2VvdmVyLWV0YyJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InNwZWNpYWwtb2NjYXNpb24tb3ItdGhlbWUtYmlydGhkYXktd2VkZGluZy1jYXJuaXZhbC10YWtlb3Zlci1ldGMiLCJsYWJlbCI6IlNwZWNpYWwgT2NjYXNpb24gb3IgVGhlbWUgKEJpcnRoZGF5LCBXZWRkaW5nLCBDYXJuaXZhbCwgVGFrZW92ZXIsIGV0Yy4pIn1dfQ=="/>&#13;
		<field type="text" label="Primary Contact Email" name="primary-contact-email" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770948527021" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicHJpbWFyeS1jb250YWN0LWVtYWlsIl0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoicHJpbWFyeS1jb250YWN0LWVtYWlsIiwibGFiZWwiOiJQcmltYXJ5IENvbnRhY3QgRW1haWwifV19"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770949246999" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicGFyYWdyYXBoLTMiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJwYXJhZ3JhcGgtMyIsImxhYmVsIjoiXCJQbGVhc2UgZW50ZXIgZGV0YWlscyBleGFjdGx5IGFzIHNob3duIG9uIGdvdmVybm1lbnQgSURcIiJ9XX0="/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1770947164160" rule="eyJ3aGVuRmllbGQiOiJpcy10aGlzLWEtZ3JvdXAtYm9va2luZy01LXRyYXZlbGVycyIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiaGVhZGVyLTUiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJoZWFkZXItNSIsImxhYmVsIjoiR3JvdXAgQm9va2luZyAoNSsgVHJhdmVsZXJzKSBJZiB5b3UgYXJlIGJvb2tpbmcgZm9yIDUgb3IgbW9yZSB0cmF2ZWxlcnMsIHBsZWFzZSBjb21wbGV0ZSB0aGUgc2VjdGlvbiBiZWxvdyJ9XX0="/>&#13;
		<field type="header" subtype="h1" label="Cruise Loyalty / Rewards Information (If Applicable)"/>&#13;
		<field type="paragraph" subtype="p" label="If you have sailed before, please enter your cruise line loyalty number below.&amp;nbsp; This helps us apply past guest discounts and special offers."/>&#13;
		<field type="checkbox-group" label="Which Cruise Line Loyalty Program Do You Have?" name="which-cruise-line-loyalty-program-do-you-have">&#13;
			<option label="Carnival - VIFP" value="carnival-vifp">Carnival - VIFP</option>&#13;
			<option label="Royal Caribbean - Crown &amp; Anchor" value="royal-caribbean-crown-anchor">Royal Caribbean - Crown &amp; Anchor</option>&#13;
			<option label="Celebrity- Captain's Club" value="celebrity-captains-club">Celebrity- Captain's Club</option>&#13;
			<option label="Virgin Voyages - Sailing Club" value="virgin-voyages-sailing-club">Virgin Voyages - Sailing Club</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Guest Information (All Travelers) Max 4"/>&#13;
		<field type="paragraph" subtype="p" label="&quot;Please enter details exactly as shown on government ID&quot;" className="field-hidden"/>&#13;
		<field type="header" subtype="h1" label="Traveler #1"/>&#13;
		<field type="text" required="true" label="First Name, Middle Name (if any), Last Name (as on ID/passport)" name="first-name-middle-name-if-any-last-name-as-on-idpassport" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Birth&amp;nbsp;" name="date-of-birth-" className="form-control"/>&#13;
		<field type="text" label="Cruise Loyalty Number (if applicable)" name="cruise-loyalty-number-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveler #2"/>&#13;
		<field type="text" required="true" label="First Name, Middle Name (if any), Last Name (as on ID/passport)" name="text-1770926393507" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Birth" name="date-1770925332205" className="form-control"/>&#13;
		<field type="text" label="Cruise Loyalty Number (if applicable)" name="text-1770926379551" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveler #3"/>&#13;
		<field type="text" label="First Name, Middle Name (if any), Last Name (as on ID/passport)" name="text-1770926411592" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of Birth" name="date-1770925338315" className="form-control"/>&#13;
		<field type="text" label="Cruise Loyalty Number (if applicable)" name="text-1770926428776" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Traveler #4"/>&#13;
		<field type="date" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Cruise Loyalty Number (if applicable)" name="text-1770926495045" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Estimated Budget Per Person" name="select-1768605277286" multiple="multiple" className="form-control">&#13;
			<option label="Under $1000" value="under-1000">Under $1000</option>&#13;
			<option label="$1000-$1,500" value="10001500">$1000-$1,500</option>&#13;
			<option label="$1,500-$2000" value="15002000">$1,500-$2000</option>&#13;
			<option label="$2000+" value="2000">$2000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Special Occasion" name="checkbox-group-1768605783619">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Group Trip" value="group-trip">Group Trip</option>&#13;
			<option label="Girls Trip" value="girls-trip">Girls Trip</option>&#13;
			<option label="Bachelor/Bachelorette" value="bachelorbachelorette">Bachelor/Bachelorette</option>&#13;
			<option label="Guys Trip" value="guys-trip">Guys Trip</option>&#13;
		</field>&#13;
		<field type="textarea" label="Additional Requests/ Notes" placeholder="Tell us anything important (celebrations  accessibility needs  room preferences  budget flexibility  etc.)" name="textarea-1768606020622" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Cruise Travel Document Notice Cruise travel document requirements vary by cruise line, itinerary, and destination. While some closed-loop cruises may allow U.S. citizens to travel with a certified birth certificate and valid government-issued photo ID, many cruises require a valid passport, and some cruise lines require passports for all sailings. Hospital-issued birth certificates are not accepted. A passport is strongly recommended. Live In The Dash will assist with verification; however, travelers are responsible for ensuring all required documents are valid prior to departure." className="field-hidden"/>&#13;
		<field type="checkbox-group" label="Travel Document Acknowledgement&amp;nbsp;" name="travel-document-acknowledgement-">&#13;
			<option label="I understand and acknowledge the cruise travel document requirements." value="i-understand-and-acknowledge-the-cruise-travel-document-requirements">I understand and acknowledge the cruise travel document requirements.</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you have a passport?" name="radio-group-1768606233915">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If needed passport must be valid at least 6 months beyond your return date." name="text-1768606984550" subtype="text" className="form-control"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768976202576" rule="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"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>