<form-template>
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>
		<field type="header" subtype="h2" label="Pre-departure information"/>
		<field type="header" subtype="h3" label="Passport details"/>
		<field type="paragraph" subtype="p" label="It is important that your name matches your passport EXACTLY.&amp;nbsp; You could be denied boarding&amp;nbsp; or asked to purchase a new ticket at the counter if your passport does not match your ticket exactly.&amp;nbsp; &amp;nbsp;If you have other traveling companions, please provide the exact information for each passenger in the boxes below.&amp;nbsp; &amp;nbsp;If you do not have a passport, please read the final paragraph very carefully and provide the names as they appear on government issued photo identification and/or birth certificates for children under 16.&amp;nbsp; &amp;nbsp; The lead passenger on the reservation should be listed first.&amp;nbsp;&amp;nbsp;"/>
		<field type="paragraph" subtype="p" label="Paragraph"/>
		<field type="text" required="true" label="First name EXACTLY as it appears on your passport " name="full-name-exactly-as-it-appears-on-your-passport-" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Middle name EXACTLY&amp;nbsp; as it&amp;nbsp; appears on your passport" description="If you have no middle name  please just enter n/a" name="middle-name-exactly-as-it-appears-on-your-passport" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Last name EXACTLY as it appears on your passport - please include any suffix such as Jr., III, etc.. only if it appears on your passport.&amp;nbsp;&amp;nbsp;" name="last-name-exactly-as-it-appears-on-your-passport-please-include-any-suffix-such-as-jr-iii-etc-only-if-it-appears-on-your-passport-" subtype="text" className="form-control"/>
		<field type="date" required="true" label="Date of birth" name="birthday" value="mm/dd/yy" className="form-control"/>
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>
		<field type="text" label="Passport Issue Date" name="passport-issue-date" value="mm/dd/yy" subtype="text" className="form-control"/>
		<field type="text" label="Passport Expiration Date" name="passport-expiration-date" value="mm/dd/yy" subtype="text" className="form-control"/>
		<field type="text" label="Passport issuing country" description="Which country issued your passport" name="passport-country" subtype="text" className="form-control"/>
		<field type="text" label="Nationality&amp;nbsp;" description="Which country issued your passport" name="text-1511925148362" subtype="text" className="form-control"/>
		<field type="header" subtype="h1" label="Additional Travelers in Your Party&amp;nbsp;"/>
		<field type="textarea" label="Passenger #2: Full Name As It Appears on Passport, Date of Birth, Passport Number, Passport Issue Date and Expiration Date, Country of Issue, Nationality&amp;nbsp;" name="passenger-two-full-name-date-of-birth-and-additional-passport-information-" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Passenger #3: Full Name As It Appears on Passport, Date of Birth, Passport Number, Passport Issue Date and Expiration Date, Country of Issue, Nationality" name="passenger-three-full-name-date-of-birth-and-additional-passport-information-" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Passenger #4: Full Name As It Appears on Passport, Date of Birth, Passport Number, Passport Issue Date and Expiration Date, Country of Issue, Nationality" name="passenger-four-full-name-date-of-birth-and-additional-passport-information-" subtype="textarea" className="form-control"/>
		<field type="header" subtype="h3" label="Address"/>
		<field type="textarea" required="true" label="Please type your complete mailing address below." name="please-type-your-complete-mailing-address-below" subtype="textarea" className="form-control"/>
		<field type="header" subtype="h3" label="Emergency Contact - Someone that we may contact while you are on your trip for emergency purposes."/>
		<field type="text" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>
		<field type="text" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>
		<field type="text" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>
		<field type="header" subtype="h3" label="Additional Information"/>
		<field type="textarea" label="Please list any frequent flyer numbers, TSA&amp;nbsp; pre-check numbers, Global Entry, rental car, hotel, or cruise line loyalty numbers that you would like for us to keep on file for you.  " name="please-list-any-frequent-flyer-numbers-tsa-precheck-numbers-rental-car-hotel-or-cruise-line-loyalty-numbers-that-you-would-like-for-us-to-keep-on-file-for-you-" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Do you have any dietary restrictions or food allergies?&amp;nbsp;" name="dietary-restrictions" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Are you celebrating anything special on your trip (birthday, graduation, anniversary etc...)?" name="are-you-celebrating-anything-special-on-your-trip-birthday-graduation-anniversary-etc" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Anything else you think we should know? (Special requests, traveling with a group, comments, notes, etc.)" name="additional-notes" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Do you have any medical conditions we need to be aware of or special needs that you might need noted in your reservation?" description="Please let us know if you will need wheelchair assistance, sharps containers, etc.. " name="medical-conditions" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Airline Seating Preference for your Party (Please describe)&amp;nbsp;" description="Ex. Two isles across from each other  a row of three and an isle, window and middle etc..." name="airline-seating-preference-for-your-party-please-describe-" subtype="textarea" className="form-control"/>
		<field type="select" label="Room Preferences " description="Please select room preferences below (select all that applies)" name="room-preferences-" multiple="true" className="form-control">
			<option label="Smoking" value="smoking" selected="true">Smoking</option>
			<option label="Non-smoking" value="nonsmoking">Non-smoking</option>
			<option label="King bed" value="king-bed">King bed</option>
			<option label="Two queen beds/doubles" value="two-queen-bedsdoubles">Two queen beds/doubles</option>
		</field>
		<field type="textarea" label="Do you have any information that we should know to help make your trip as enjoyable as possible (specific requests for room type/location, favorite beverages or foods, activities you enjoy etc...)?" name="do-you-have-any-other-room-requests-we-are-happy-to-make-these-requests-on-your-behalf-but-we-can-not-guarantee-they-will-be-met" subtype="textarea" className="form-control"/>
		<field type="paragraph" subtype="p" label="Important Information Regarding Travel Documentation:Domestic Travel:&amp;nbsp;&amp;nbsp;All U.S. citizens must have a government issued photo ID or a passport to travel domestically.&amp;nbsp; Identification must match airline tickets (names, dates of birth, and gender) exactly.&amp;nbsp; TSA requires all states to have Real ID compliant identification by the end of 2020.&amp;nbsp; It is the traveler's responsibility to ensure that their identification is compliant with federal and airport regulations.&amp;nbsp; Children under the age of 16 do not need government issued identification to travel domestically, but it always smart to travel with birth certificates.&amp;nbsp; Children ages will need to travel with 16-18&amp;nbsp; valid photo identification.&amp;nbsp;&amp;nbsp;International Travel:&amp;nbsp;&amp;nbsp;All U.S. citizens (even infants) must have a valid passport BOOK&amp;nbsp; (valid for 6 months upon return from the trip) in order to travel by air internationally.&amp;nbsp; Passports CARDS are not valid for air travel.&amp;nbsp; Please note that children traveling internationally without both legal parents may need a notarized letter of permission from the absent parent to travel abroad. If you are traveling with a minor and the legal parents/guardians are not traveling with you (as in the case of a group of friends traveling with only a few chaperones, grandparents with grandchildren etc...), you MUST have a notarized form from the legal parents or guardians granting you permission to depart the United States with the child.&amp;nbsp; &amp;nbsp;Ten Palms Travel can provide you with this form.&amp;nbsp; Please inquire.&amp;nbsp;Cruise Passengers:&amp;nbsp;A parent, grandparent, or legal guardian must accompany all cruise passengers under the age of 21.  While passports are HIGHLY recommended for cruise passengers, you may also use your government issued photo ID AND an original or certified copy of your birth certificate, if you are on a closed loop cruise departing and returning from a US port.  Copies must have either a raised seal or a multi color embossed seal.  In addition, if your ID name reads differently from your birth certificate, it is wise to bring documentation showing the name change (marriage certificate, divorce decree etc&#x2026;.) . If you are cruising with minors whose parents/guardians will not be traveling, you must have a notarized letter granting permission for travel.&amp;nbsp;&amp;nbsp;An Important Note Regarding Foreign Travel:&amp;nbsp;&amp;nbsp;Ten Palms Travel is not to be held liable for advising clients of their ability to travel as it applies to legal reasons.&amp;nbsp; &amp;nbsp;We will not ask you for information regarding your criminal history.&amp;nbsp; If you have a felony/misdemeanor on your record (including DUI/DWI), outstanding child support payments etc... it is possible for you to be denied entry into a country or to be denied entrance back into the United States upon return from your trip.&amp;nbsp; It is the traveler's responsibility to make certain that their record is cleared for international travel by consulting with the appropriate legal authorities.&amp;nbsp; It is VERY IMPORTANT that you review your specific situation with an attorney and/or appropriate legal authorities before booking or paying for your trip if you are doubtful.&amp;nbsp; Ten Palms Travel will not be held responsible for any cancellation penalties&amp;nbsp; incurred to our clients due to inability to travel for legal reasons.&amp;nbsp;&amp;nbsp;For More Information:Please visit https://travel.state.gov as your best source for information regarding questions related to travel documentation.&amp;nbsp;&amp;nbsp;"/>
	</fields>
</form-template>