Share your information with Tonia Ridler

Tonia Ridler

Travel By Tonia

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="3-2-1 Cancun! With Brad and Bryan @ Hard Rock!"/>&#13;
		<field type="paragraph" subtype="p" label="Hello! Please fill out the questions below so I can get you more information about the come along trip Jan 27-31, 2027 to HARD ROCK CANCUN!"/>&#13;
		<field type="header" subtype="h2" label="Traveler 1"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Middle name" name="middle-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="date" required="true" label="Birthday" name="birthday" 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="How many nights would you like pricing for?" name="checkbox-group-1777641100918" other="true">&#13;
			<option label="4 Nights (Jan 27-31)" value="4-nights-jan-2731">4 Nights (Jan 27-31)</option>&#13;
			<option label="5 Nights" value="5-nights">5 Nights</option>&#13;
			<option label="6 Nights" value="6-nights">6 Nights</option>&#13;
			<option label="7 Nights" value="7-nights">7 Nights</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like pricing and information for travel insurance?" name="checkbox-group-1777641234401" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like prices for airfare?&amp;nbsp;" name="checkbox-group-1777641234921" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If the last question you answered yes, what airport would you like to fly out of?" name="checkbox-group-1777641348003" other="true">&#13;
			<option label="MSP" value="msp">MSP</option>&#13;
			<option label="MKE" value="mke">MKE</option>&#13;
			<option label="FSD" value="fsd">FSD</option>&#13;
			<option label="CWA" value="cwa">CWA</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="If there is anyone else traveling in your party please fill out the text area below with their FIRST, MIDDLE, and LAST name along with their date of birth.&amp;nbsp;"/>&#13;
		<field type="text" label="Additional Travelers" name="text-1777641827085" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
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  </body>
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