<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="CLIENT INFORMATION"/> <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="Birthday" name="birthday" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" label="This is my:" inline="true" name="this-is-my"> <option label="Cell Phone" value="cell-phone">Cell Phone</option> <option label="Home Phone" value="home-phone">Home Phone</option> <option label="Work Phone" value="work-phone">Work Phone</option> </field> <field type="header" subtype="h2" label="Address"/> <field type="text" 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" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="ABOUT YOUR TRIP"/> <field type="textarea" required="true" label="Who will be traveling with you? Please list all full names (including middle) and birthdates." name="who-all-will-be-traveling-with-you-please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport" className="form-control"/> <field type="text" required="true" label="The dates of the Ryder Cup hotel package are Sept 28 to Oct.&nbsp; If you intend to extend your stay, please advise of your travel dates below.&nbsp;" name="where-would-you-like-to-go" subtype="text" className="form-control"/> <field type="date" label="When do you plan to arrive?&nbsp;" name="when-would-you-like-to-depart" className="form-control"/> <field type="date" label="When do you plan to return home?&nbsp;" name="when-would-you-like-to-return" className="form-control"/> <field type="radio-group" label="Do you need additional trip planning assistance beyond the Ryder Cup package?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="If you marked yes above, please share more details of your plans." name="is-there-anything-else-you-must-do-or-see" className="form-control"/> <field type="header" subtype="h1" label="Antilia Travel Client Agreement"/> <field type="paragraph" subtype="p" label="When you retain Antilia Travel 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."/> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="paragraph" subtype="p" label="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.antiliatravel.com/terms-conditions"/> <field type="checkbox-group" required="true" label="Antilia Travel Client Agreement." name="antilia-travel-client-agreement"> <option label="I agree." value="i-agree">I agree.</option> </field> <field type="header" subtype="h1" label="Professional Service Fee"/> <field type="paragraph" subtype="p" label="&nbsp;We're providing a professional service and as such, charge fees for it. The fees cover our time, and allows us to provide a personalized service that an online agency can't provide. This service includes support before, during and after your vacation. If there are any issues with your trip, we will be here to help and advocate on your behalf. *No work will begin until the planning fee has been paid, but you won't be charged until we've had a chance to discuss your trip.*&nbsp; This fee is non-refundable and is separate from the cost of your trip. For highly complex trips or trips departing in less than 60 days, Antilia Travel reserves the right to increase these fees. If this is necessary, the adjusted fee will be disclosed in writing and must be agreed to prior to beginning any research or planning for your trip.&nbsp;&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="paragraph" subtype="p" label="All Ryder Cup Package bookings are subject to a $100 non-refundable administration and servicing fee.&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="paragraph" subtype="p" label="Terms &amp; Conditions: All planning fees are non-refundable/non-transferable, regardless of the reason for change or cancellation. Fees are charged based on the time required to create the itinerary, therefore it is not possible to return the funds for any reason. Should the dates/itinerary need to be adjusted, the itinerary fee will be required again due to the time required to change/cancel and re-book items."/> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="checkbox-group" required="true" label="Professional Fee" name="professional-service-fee"> <option label="I agree." value="i-agree">I agree.</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="Travel Insurance Acknowledgement"/> <field type="paragraph" subtype="p" label="Emergencies can happen when you least expect them. Antilia Travel highly recommends that all clients purchase a travel insurance policy to protect their investment in their travel. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all.&nbsp; And, keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of Trip Cancellation, Trip Delay, Trip Interruption, Missed Connection, Baggage Loss, Theft or Damage, Baggage Delay, Emergency Medical and Dental Expenses, and Emergency Medical Transportation, among other unforeseen circumstances. Please also note that in order for you to obtain coverage for certain pre-existing conditions, or for supplier default, your policy must be purchased at the time of booking or shortly thereafter (depending on the terms of the policy). Please understand that we are not registered insurance agents, and cannot legally provide specific advice or information regarding insurance. We will gladly secure a quote for you, upon request, and if Antilia Travel does not, or is not legally able to secure coverage on your behalf, it is our strong recommendation that you purchase a policy on your own. I acknowledge that Antilia Travel has recommended or offered travel insurance protection to me. Should I choose not to purchase such a policy, I accept all responsibility for declining to secure coverage.&nbsp;"/> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="checkbox-group" required="true" label="Travel Insurance Acknowledgement" name="travel-insurance-acknowledgement"> <option label="I agree." value="i-agree">I agree.</option> </field> <field type="paragraph" subtype="p"/> <field type="radio-group" required="true" label="Would you like an insurance quote included with your trip proposal?&nbsp;" name="would-you-like-an-insurance-quote-included-with-your-trip-proposal-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> </fields> </form-template> </body> </html>
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