Christina Garcia

Point Me To Paradise Travel

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		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" 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="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How did you hear about the Lei'd Back Ladies Kauai Trip?" name="how-did-you-hear-about-my-services">&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="TikTok" value="tiktok">TikTok</option>&#13;
			<option label="Friend/Family" value="friendfamily">Friend/Family</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your preferred departure city?&amp;nbsp;" name="what-is-your-preferred-departure-port-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you have a travel partner for this trip?" name="do-you-have-a-travel-partner-for-this-trip">&#13;
			<option label="YES! " value="yes-">YES! </option>&#13;
			<option label="No, please match me" value="no-please-match-me">No, please match me</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="If you answered yes to having a travel partner, what is their name?" name="how-many-staterooms-will-you-require" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="How soon are you looking to book?&amp;nbsp;" description="I understand that any prices given to me are subject to change until booked and I am getting the lowest prices available. at the time of quote. Using a travel agent/agency is  a free service that I do not have to pay for." name="how-soon-are-you-looking-to-book-">&#13;
			<option label="I am ready to book soon within a week" value="i-am-ready-to-book-soon-within-a-week">I am ready to book soon within a week</option>&#13;
			<option label="Within a month" value="within-a-month">Within a month</option>&#13;
			<option label="I am not sure if I am ready" value="i-am-not-sure-if-i-am-ready">I am not sure if I am ready</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Does anyone in your party have any special conditions or considerations that I need to be aware of?" description="allergies  food sensitivities  medical conditions  etc" name="does-anyone-in-your-party-have-any-special-conditions-or-considerations-that-i-need-to-be-aware-of">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have any questions or concerns regarding this group trip?&amp;nbsp;" name="do-you-have-any-questions-or-concerns-regarding-this-group-trip-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="We love meeting our travelers, would you like to schedule a meeting remotely or in person?&amp;nbsp;" name="i-love-to-getting-to-know-my-clients-learning-about-their-likes-and-preferences-i-would-love-to-jump-on-a-call-with-you-at-your-convenience-">&#13;
			<option label="Yes, online is best for me" value="yes-online-is-best-for-me">Yes, online is best for me</option>&#13;
			<option label="Yes, I am local to the Galveston Co area and would love to meet" value="yes-i-am-local-to-the-galveston-co-area-and-would-love-to-meet">Yes, I am local to the Galveston Co area and would love to meet</option>&#13;
		</field>&#13;
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