<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Client Information"/> <field type="text" required="true" label="First name" name="first-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" 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="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="About Your Trip"/> <field type="checkbox-group" required="true" label="What vacation type are you looking to plan?&nbsp;" name="what-vacation-type-are-you-looking-to-plan-"> <option label="Walt Disney World (Orlando)" value="walt-disney-world-orlando">Walt Disney World (Orlando)</option> <option label="Disneyland (California)" value="disneyland-california">Disneyland (California)</option> <option label="Universal Studios/ Wizarding World of Harry Potter (Orlando)" value="universal-studios-wizarding-world-of-harry-potter-orlando">Universal Studios/ Wizarding World of Harry Potter (Orlando)</option> <option label="Disney Cruise" value="disney-cruise">Disney Cruise</option> <option label="Adventures By Disney " value="adventures-by-disney-">Adventures By Disney </option> </field> <field type="date" required="true" label="When would you like to depart?&nbsp;" name="when-would-you-like-to-depart-" className="form-control"/> <field type="date" required="true" label="When would you like to return?&nbsp;" name="when-would-you-like-to-return-" className="form-control"/> <field type="checkbox-group" required="true" label="Are your dates flexible?&nbsp;" name="are-your-dates-flexible-"> <option label="Yes- I am flexible based on availability and best dates" value="yes-i-am-flexible-based-on-availability-and-best-dates">Yes- I am flexible based on availability and best dates</option> <option label="No- I have specific dates that I must maintain" value="no-i-have-specific-dates-that-i-must-maintain">No- I have specific dates that I must maintain</option> </field> <field type="text" required="true" label="What is your departure city?&nbsp;" name="what-is-your-departure-city-" subtype="text" className="form-control"/> <field type="text" required="true" label="What is the reason for the trip?&nbsp;" name="what-is-the-reason-for-the-trip-" subtype="text" className="form-control"/> <field type="text" required="true" label="Will you be celebrating anything during this trip? If so, what is the celebration and what date would you like to celebrate?&nbsp;" name="will-you-be-celebrating-anything-during-this-trip-if-so-what-is-the-celebration-and-what-date-would-you-like-to-celebrate-" subtype="text" className="form-control"/> <field type="text" required="true" label="How many adults will be traveling?&nbsp;" name="how-many-adults-will-be-traveling-" subtype="text" className="form-control"/> <field type="text" required="true" label="How many children (if applicable)?&nbsp;" name="how-many-children-if-applicable-" subtype="text" className="form-control"/> <field type="text" label="If you're planning on staying in multiple rooms, can you group by room below?" name="if-youre-planning-on-staying-in-multiple-rooms-can-you-group-by-room-below" subtype="text" className="form-control"/> <field type="text" required="true" label="Please list the ages of all children (at time of travel)&nbsp;" name="please-list-the-ages-of-all-children-at-time-of-travel-" subtype="text" className="form-control"/> <field type="text" label="If you will need flights, please list all names (including middle) and birthdays:&nbsp;" name="if-you-will-need-flights-please-list-all-names-including-middle-and-birthdays-" subtype="text" className="form-control"/> <field type="select" required="true" label="At what phase of planning are you in?&nbsp;" name="at-what-phase-of-planning-are-you-in-" className="form-control"> <option label="We haven’t done a thing - HELP!" value="we-havent-done-a-thing-help">We haven’t done a thing - HELP!</option> <option label="We have dates, but we need everything else" value="we-have-dates-but-we-need-everything-else">We have dates, but we need everything else</option> <option label="Flights are all booked...now help us fill in the blanks!" value="flights-are-all-bookednow-help-us-fill-in-the-blanks">Flights are all booked...now help us fill in the blanks!</option> <option label="We have hotels and flights already booked, but we need park planning" value="we-have-hotels-and-flights-already-booked-but-we-need-park-planning">We have hotels and flights already booked, but we need park planning</option> </field> <field type="radio-group" required="true" label="What is your budget for all travelers?&nbsp;" description="This just gives me a general starting point and can always be changed later." name="what-is-your-budget-for-all-travelers-"> <option label="$3,000 - $5,000" value="3000-5000">$3,000 - $5,000</option> <option label="$5, 000 - $7,500" value="5-000-7500">$5, 000 - $7,500</option> <option label="$7,500 - $10,000" value="7500-10000">$7,500 - $10,000</option> <option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option> <option label="$15,000+" value="15000">$15,000+</option> </field> <field type="textarea" required="true" label="Will you be booking any portion of your trip with points?&nbsp;" description="If so which pieces?" name="will-you-be-booking-any-portion-of-your-trip-with-points-" className="form-control"/> <field type="checkbox-group" required="true" label="What travel components would you like us to assist you with?&nbsp;" description="Check all that apply" name="what-travel-components-would-you-like-us-to-assist-you-with-"> <option label="Flights" value="flights">Flights</option> <option label="Park Tickets" value="park-tickets">Park Tickets</option> <option label="Accommodations" value="accommodations">Accommodations</option> <option label="Car Rental" value="car-rental">Car Rental</option> <option label="Park Hopper Tickets" value="park-hopper-tickets">Park Hopper Tickets</option> <option label="Park Hopper Plus Tickets (includes water parks)" value="park-hopper-plus-tickets-includes-water-parks">Park Hopper Plus Tickets (includes water parks)</option> <option label="Airport Transfers" value="airport-transfers">Airport Transfers</option> <option label="Insurance" value="insurance">Insurance</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="What is your preferred accommodation? Please note that certain Disney options are only available to those in Deluxe on-property accommodations." name="what-is-your-preferred-accommodation-please-note-that-certain-disney-options-are-only-available-to-those-in-deluxe-onproperty-accommodations"> <option label="Economical (does not need to be on park property)" value="economical-does-not-need-to-be-on-park-property">Economical (does not need to be on park property)</option> <option label="Moderate (does not need to be on park property)" value="moderate-does-not-need-to-be-on-park-property">Moderate (does not need to be on park property)</option> <option label="Value (located on park property)" value="value-located-on-park-property">Value (located on park property)</option> <option label="Moderate (located on park property)" value="moderate-located-on-park-property">Moderate (located on park property)</option> <option label="Luxury (does not need to be on park property)" value="luxury-does-not-need-to-be-on-park-property">Luxury (does not need to be on park property)</option> <option label="Luxury (located on park property)" value="luxury-located-on-park-property">Luxury (located on park property)</option> </field> <field type="textarea" label="What are your amenity must-haves?&nbsp;" description="Is there anything that you would want your hotels to have (i.e. bar on-site restaurant pool etc.)?" name="what-are-your-amenity-musthaves-" className="form-control"/> <field type="checkbox-group" required="true" label="What experiences are you looking for:&nbsp;" description="Check all that apply." name="what-experiences-are-you-looking-for-"> <option label="Genie+ " value="genie-">Genie+ </option> <option label="Park-hopper passes" value="parkhopper-passes">Park-hopper passes</option> <option label="Water park (Typhoon Lagoon, Blizzard Beach, Volcano Bay)" value="water-park-typhoon-lagoon-blizzard-beach-volcano-bay">Water park (Typhoon Lagoon, Blizzard Beach, Volcano Bay)</option> <option label="Magic bands" value="magic-bands">Magic bands</option> <option label="On-property dining reservations" value="onproperty-dining-reservations">On-property dining reservations</option> <option label="VIP park guides" value="vip-park-guides">VIP park guides</option> <option label="Backstage tours" value="backstage-tours">Backstage tours</option> <option label="Photo Package" value="photo-package">Photo Package</option> <option label="Bibbidi Bobbidi Boutique/Droid Depot" value="bibbidi-bobbidi-boutiquedroid-depot">Bibbidi Bobbidi Boutique/Droid Depot</option> <option label="Harry Potter Package" value="harry-potter-package">Harry Potter Package</option> <option label="Dining Plan" value="dining-plan">Dining Plan</option> </field> <field type="textarea" label="What are your “must have” experiences for this vacation?&nbsp;" name="what-are-your-must-have-experiences-for-this-vacation-" className="form-control"/> <field type="textarea" label="What are you most excited about for this vacation?&nbsp;" name="what-are-you-most-excited-about-for-this-vacation-" className="form-control"/> <field type="radio-group" required="true" label="Have you been to this/these theme park(s) before?&nbsp;" name="have-you-been-to-thisthese-theme-parks-before-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="What else would you like me to know about your ideal vacation?&nbsp;" name="what-else-would-you-like-me-to-know-about-your-ideal-vacation-" className="form-control"/> <field type="text" label="Do any travelers have allergies that we should be aware of?&nbsp;" description="We will do our best to accommodate" name="do-any-travelers-have-allergies-that-we-should-be-aware-of-" subtype="text" className="form-control"/> <field type="textarea" label="Are there any reduced mobility travelers in your party? If so, please describe the level of physical restrictions.&nbsp;" name="are-there-any-reduced-mobility-travelers-in-your-party-if-so-please-describe-the-level-of-physical-restrictions-" className="form-control"/> <field type="text" label="Who can we thank for referring you to us?&nbsp;" name="who-can-we-thank-for-referring-you-to-us-" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Other important information"/> <field type="paragraph" subtype="p" label="Each country holds different views of past criminal offenses, whether within or outside of their boundaries. If you have a current or prior criminal offense, contact that country directly for entry and exit requirements. You can visit the US State Department Website for further information about these requirements. See, https://travel.state.gov/content/travel.html. We do not inquire about an individual’s criminal record in the interest of respecting our Clients’ privacy. For example, if traveling to or through Canada, individuals with a Driving While Intoxicated (DWI) record or with judgements for unpaid child support should review current entry requirements. See: https://www.canada.ca."/> <field type="paragraph" subtype="p" label="Minors traveling with one parent, and/or without both parents, may be stopped and not admitted, unless authenticated and verified consent forms are provided to the authorities; please see https://help.cbp.gov for additional information."/> <field type="paragraph" subtype="p" label="If you are a U.S. citizen planning to drive while traveling abroad, find out the driver’s license requirements for the country you are visiting. You may be able to drive in another country with your state-issued U.S. driver’s license or with an International Driving Permit (IDP). See: https://www.usa.gov/international-drivers-license"/> <field type="header" subtype="h1" label="Client Agreement"/> <field type="paragraph" subtype="blockquote" label="When you retain The TravelSmith to help plan your travel, you're hiring a professional travel advisor to ensure that your trip is tailored to your taste, preferences, and budget. You get the benefit of our skill, experience and training, our professional relationships, and our industry connections. By checking the box below and submitting this form, you acknowledge that you are hiring us to plan your trip and that you have read and agree to our Terms and Conditions of booking, which are located at: https://www.thetravelsmith.net/terms"/> <field type="checkbox-group" required="true" label="Client Agreement" name="client-agreement"> <option label="I agree" value="i-agree">I agree</option> </field> <field type="paragraph" subtype="p" label="The TravelSmith Travel Agency custom curates itineraries based on client needs and wishes. There are 2 different service levels offered: Free and Concierge. Please review our https://thetravelsmith.net/how-it-works to familiarize yourself with the inclusions of each of these levels. For our Concierge Level Services, due to the amount of time allocated to the customization of each proposal, there is a planning fee due prior to a proposal being compiled, created and/or presented. By moving forward and scheduling a call, you agree and understand that if you choose our Concierge Level Service, you will be quoted a planning fee based on the intricacies of your specific trip. All planning fees are non-refundable, regardless of trip outcome."/> <field type="checkbox-group" required="true" label="Client Fee Understanding" name="client-fee-understanding"> <option label="I agree" value="i-agree">I agree</option> </field> <field type="paragraph" subtype="p" label="The TravelSmith acts solely as a booking agent for disclosed principal Suppliers and is not the source or provider of any travel service. Each Supplier is an independent entity with its own management and is not subject to the control of The TravelSmith. For this reason, you will see all pricing as bundled rates and not broken out by component. Our partners do not provide component pricing to protect their contracts, therefore The TravelSmith is not able to provide /disclose component pricing. Do you agree and understand that you will receive all pricing as a "package rate?""/> <field type="checkbox-group" required="true" label="Client Package Agreement" name="client-package-agreement"> <option label="I agree" value="i-agree">I agree</option> </field> </fields> </form-template> </body> </html>
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