<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Additional Traveler Change Policy"/> <field type="paragraph" subtype="p" label="Welcome to your travel journey arranged by Trips By Us, LLC. Please note that a planning fee has been covered by your main trip planner, and your selected accommodations will be provided after completing this form. To ensure your complete satisfaction, we offer one complimentary revision to your plans. Any additional changes will incur a non-refundable fee of $25 each. This policy helps us meet each traveler's needs with precision and care. Thank you for choosing Trips By Us, LLC. I look forward to making your trip an exceptional experience."/> <field type="header" subtype="h2" label="Contact Information"/> <field type="text" required="true" 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 (nickname)" name="preferred-name" subtype="text" className="form-control"/> <field type="date" required="true" label="Date of birth" name="birthday" className="form-control"/> <field type="date" label="Anniversary" name="anniversary" className="form-control"/> <field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Accept Text Messages?" name="accept-text-messages"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <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="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Passport Information"/> <field type="radio-group" required="true" label="Have you applied for your passport?" description="Passports are required for most international travel" name="have-you-applied-for-your-passport"> <option label="I have a passport" value="i-have-a-passport">I have a passport</option> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Full name as it appears on passport" description="Travel documents must match name as it appears on passport" placeholder="If you do not have your passport yet enter how your name will appear" name="passport-name" subtype="text" className="form-control"/> <field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="file" label="Passport photo" name="passport_photo" subtype="file" className="form-control"/> <field type="radio-group" required="true" label="Gender" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="X" value="other">X</option> </field> <field type="date" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/> <field type="date" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/> <field type="text" label="What is your departure airport?" name="what-is-your-departure-airport" subtype="text" className="form-control"/> <field type="text" required="true" label="Name of person who's trip you are joining" name="referred-by" subtype="text" className="form-control"/> <field type="text" label="Name of person you are sharing a room with" placeholder="They will also need to fill out the Additional Traveler form" name="sharing-room-with" subtype="text" className="form-control"/> <field type="text" required="true" label="Emergency Contact Name" name="emergency-contact-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Emergency Contact Phone Number" name="emergency-contact-phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Emergency Contact Relationship" name="emergency-contact-relationship" subtype="text" className="form-control"/> <field type="textarea" label="Any Medical or Mobility conditions that we should be on record?" name="any-medical-or-mobility-conditions-that-we-should-be-on-record" className="form-control"/> <field type="textarea" label="Dietary Needs/Food Allergies?" name="dietary-needsfood-allergies" className="form-control"/> <field type="text" label="What is your favorite color?" name="what-is-your-favorite-color" subtype="text" className="form-control"/> <field type="textarea" label="What are your preferred snacks and beverages? (the more specific the better!)" name="what-are-your-preferred-snacks-and-beverages-the-more-specific-the-better" className="form-control"/> <field type="textarea" label="Any additional information you would like to provide?" name="any-additional-information-you-would-like-to-provide" className="form-control"/> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="radio-group" label="Seat preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Middle" value="middle">Middle</option> <option label="Aisle" value="aisle">Aisle</option> </field> <field type="radio-group" label="Cabin Experience" name="cabin-experience" other="true"> <option label="Economy/Main Cabin" value="economymain-cabin">Economy/Main Cabin</option> <option label="Comfort Plus" value="comfort-plus">Comfort Plus</option> <option label="First Class" value="first-class">First Class</option> <option label="Business Class" value="business-class">Business Class</option> </field> <field type="radio-group" label="Bed preference" name="bed-preference"> <option label="King" value="king">King</option> <option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option> </field> <field type="radio-group" label="Room type" name="room-type" other="true"> <option label="Garden View" value="garden-view">Garden View</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Ocean Front" value="ocean-front">Ocean Front</option> <option label="Swim Up" value="swim-up">Swim Up</option> </field> <field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/> <field type="radio-group" required="true" label="Do you plan to purchase Travel Insurance?" name="do-you-plan-to-purchase-travel-insurance"> <option label="Yes, I will research and purchase my own travel insurance" value="yes-i-will-research-and-purchase-my-own-travel-insurance">Yes, I will research and purchase my own travel insurance</option> <option label="No, I will not purchase travel insurance I understand that I am solely responsible for any cancellation penalties and out of pocket expenses incurred I will also make my own medical and any other provisions in the event of an emergency while I am traveling this waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip described above" value="no-i-will-not-purchase-travel-insurance-i-understand-that-i-am-solely-responsible-for-any-cancellation-penalties-and-out-of-pocket-expenses-incurred-i-will-also-make-my-own-medical-and-any-other-provisions-in-the-event-of-an-emergency-while-i-am-traveling-this-waiver-confirms-that-i-voluntarily-decline-travel-insurance-and-travel-protection-insurance-for-the-trip-described-above">No, I will not purchase travel insurance I understand that I am solely responsible for any cancellation penalties and out of pocket expenses incurred I will also make my own medical and any other provisions in the event of an emergency while I am traveling this waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip described above</option> </field> <field type="checkbox-group" required="true" label="Travel Insurance" name="travel-insurance"> <option label="I acknowledge that I have been advised to purchase travel insurance to protect my investment." value="i-acknowledge-that-i-have-been-advised-to-purchase-travel-insurance-to-protect-my-investment">I acknowledge that I have been advised to purchase travel insurance to protect my investment.</option> </field> <field type="checkbox-group" required="true" label="Terms &amp; Conditions Acceptance" name="checkbox-group-1650759814205"> <option label="I agree to Trips By Us, LLC Terms & Conditions" value="i-agree-to-trips-by-us-llc-terms-conditions">I agree to Trips By Us, LLC Terms & Conditions</option> </field> </fields> </form-template> </body> </html>
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