Share your information with Audrene Lopez

Audrene Lopez

The Heart of God Retreats LLC

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		<field type="header" subtype="h2" label="2027 Christian Cruises"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="header" subtype="h1" label="Act Now! Book by June 11th and receive:&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="- $150 onboard credit per person for Inside Staterooms."/>&#13;
		<field type="header" subtype="h1" label="&amp;nbsp;- $225 onboard credit&amp;nbsp; per person for Infinite Veranda."/>&#13;
		<field type="header" subtype="h1" label="- $400 onboard credit per person for Sky Suite &amp;amp; above"/>&#13;
		<field type="header" subtype="h1" label="To reserve your spot, please complete the credit card authorization form below to approve the $500 deposit per stateroom.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Please note: Authorized deposits will be processed on June 11, 2026. Thank you for your understanding."/>&#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 type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#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" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Second Guests Information (If Applicable)"/>&#13;
		<field type="text" label="First name (Second Guest if Applicable)" name="text-1780129612989" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Last name&amp;nbsp; (Second Guest if Applicable)" name="last-name-second-guest-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Email (Second Guest if Applicable)" name="email-second-guest-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number (Second Guest if Applicable)" name="phone-number-second-guest-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="City (Second Guest if Applicable)" name="city-second-guest-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State (Second Guest if Applicable)" name="state-second-guest-if-applicable-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country (Second Guest if Applicable)" name="country-second-guest-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday (Second Guest if Applicable)" name="birthday-second--guest-if-applicable" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="RETREAT SPECIAL ENDS JUNE 7th"/>&#13;
		<field type="checkbox-group" required="true" label="Which cruise are you interested in?" name="which-cruie-are-you-interested-in">&#13;
			<option label="2027 April Cruise with Joan Hunter &amp; Kim Robinson " value="2027-april-cruise-with-joan-hunter-kim-robinson-">2027 April Cruise with Joan Hunter &amp; Kim Robinson </option>&#13;
			<option label="2027 July Cruise with Mina &amp; Yvon Attia" value="2027-july-cruise-with-mina-yvon-attia">2027 July Cruise with Mina &amp; Yvon Attia</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Prices below include: Wifi, all inclusive drink package, taxes, fees, and&amp;nbsp; $200 conference room&amp;nbsp; fee ( This helps support the event and cover the speakers stateroom)"/>&#13;
		<field type="header" subtype="h1" label="Not included: Gratuity $18 Per Person Per Day&amp;nbsp; (Onboard credit can be applied towards Gratuity)&amp;nbsp;"/>&#13;
		<field type="checkbox-group" label="2027 April Cruise Stateroom Prices I Speakers: Joan Hunter and Kim Robinson" name="checkbox-group-1780110681673">&#13;
			<option label="Deluxe Inside Single Occupancy Stateroom $3,573.04" value="deluxe-inside-single-occupancy-stateroom-357304">Deluxe Inside Single Occupancy Stateroom $3,573.04</option>&#13;
			<option label="Infinite Veranda Single Occupancy Stateroom $ 4,279.04 " value="infinite-veranda-single-occupancy-stateroom-427904-">Infinite Veranda Single Occupancy Stateroom $ 4,279.04 </option>&#13;
			<option label="Deluxe Inside Double Occupancy Stateroom $ 1,967.04 Per Person " value="deluxe-inside-double-occupancy-stateroom-196704-per-person-">Deluxe Inside Double Occupancy Stateroom $ 1,967.04 Per Person </option>&#13;
			<option label="Infinite Veranda Double Occupancy Stateroom $ 2,220.04 Per Person " value="infinite-veranda-double-occupancy-stateroom-222004-per-person-">Infinite Veranda Double Occupancy Stateroom $ 2,220.04 Per Person </option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="2027 July Cruise Stateroom Prices I Speakers: Yvon &amp;amp; Mina Attia" name="checkbox-group-1780126416346">&#13;
			<option label="Deluxe Inside Single Occupancy Stateroom $3,916.78" value="deluxe-inside-single-occupancy-stateroom-391678">Deluxe Inside Single Occupancy Stateroom $3,916.78</option>&#13;
			<option label="Infinite Veranda Single Occupancy Stateroom $4,708.78" value="infinite-veranda-single-occupancy-stateroom-470878">Infinite Veranda Single Occupancy Stateroom $4,708.78</option>&#13;
			<option label="Deluxe Inside Double Occupancy Stateroom $2,141.78 Per Person " value="deluxe-inside-double-occupancy-stateroom-214178-per-person-">Deluxe Inside Double Occupancy Stateroom $2,141.78 Per Person </option>&#13;
			<option label="Infinite Veranda Double Occupancy Stateroom $2,537.78 Per Person " value="infinite-veranda-double-occupancy-stateroom-253778-per-person-">Infinite Veranda Double Occupancy Stateroom $2,537.78 Per Person </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Please Note: Audrene is hosting an event June 5-7. Any authorized deposits will be processed on June 11, 2026. By submitting this form, you authorize The Heart of God Retreats to charge the deposit on that date.&amp;nbsp;"/>&#13;
		<field type="text" label="Enter the amount to authorize:" name="amount" value="Authorize $500 Deposit" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Comments:" name="comments" rows="3" className="form-control"/>&#13;
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Enter the amount you would like to authorize:

Please add or choose card to authorize:

Sign and agree to the terms and conditions:

By signing below, I authorizeThe Heart of God Retreats LLC to charge the credit card provided herein.

By signing below, I acknowledge and agree to the following:

I have clicked on the link below and read and accept the Terms & Conditions, including the Cancellation Policy, Booking Terms, Cruise Contract, Disclaimer of Liability, and Passport Requirements.
I understand that all policies are subject to change.
I understand that the full Terms & Conditions can be found on the Heart of God Retreats LLC website by clicking on "Terms & Conditions", then selecting "Cruises".

Link: https://www.theheartofgodretreats.com/terms-conditions-for-cruises

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