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Shareeda Tyaire

Moms At Sea

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Moms at Sea Travel Inquiry&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="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="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Which cruise line are you looking to sail?" name="which-cruise-line-are-you-looking-to-sail">&#13;
			<option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option>&#13;
			<option label="Celebrity" value="celebrity">Celebrity</option>&#13;
			<option label="Carnival " value="carnival-">Carnival </option>&#13;
			<option label="NCL " value="ncl-">NCL </option>&#13;
			<option label="DCL" value="dcl">DCL</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have preferred travel dates?" name="do-you-have-preferred-travel-dates" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your preferred Departure port?" name="what-is-your-preferred-departure-port" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many guests total?" name="how-many-guests-total" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Any children? If so, what are their ages?" name="any-children-if-so-what-are-their-ages" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Any must haves I should know about?" name="vibe-preference">&#13;
			<option label="Perfect Day at CocoCay" value="perfect-day-at-cococay">Perfect Day at CocoCay</option>&#13;
			<option label="Diapered splash pad" value="diapered-splash-pad">Diapered splash pad</option>&#13;
			<option label="Waterslides " value="waterslides-">Waterslides </option>&#13;
			<option label="Nursey for 6M-36M" value="nursey-for-6m36m">Nursey for 6M-36M</option>&#13;
			<option label="Splash pad for potty trained kids" value="splash-pad-for-potty-trained-kids">Splash pad for potty trained kids</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What type of cabin/suite are you most interested in?" name="activity-preferences">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Neighborhood Balcony" value="neighborhood-balcony">Neighborhood Balcony</option>&#13;
			<option label="Oceanview Balcony " value="oceanview-balcony-">Oceanview Balcony </option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Cabins that  can accommodate 5+" value="cabins-that-can-accommodate-5">Cabins that  can accommodate 5+</option>&#13;
			<option label="Accessible Cabin" value="accessible-cabin">Accessible Cabin</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Eligible Discounts&amp;nbsp;" name="eligible-discounts-">&#13;
			<option label="Military " value="military-">Military </option>&#13;
			<option label="Fire/EMT" value="fireemt">Fire/EMT</option>&#13;
			<option label="Law Enforcement " value="law-enforcement-">Law Enforcement </option>&#13;
			<option label="Senior " value="senior-">Senior </option>&#13;
		</field>&#13;
		<field type="text" label="State of Residency and any appropriate Cruise Loyalty Number (If available)&amp;nbsp;" name="text-1764879337329" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please include any details you&#39;d like to share below:" name="please-include-any-details-youd-like-to-share-below" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>