Share your information with Chelsea Nash

Chelsea Nash

Think of a Wonderful Trip

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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" required="true" label="Last name" name="last-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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Check In Date" name="date-1771260690358" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Check Out Date" name="date-1771260714813" className="form-control"/>&#13;
		<field type="text" required="true" label="Are your dates flexible?" name="text-1771260860231" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are you driving or flying?" name="text-1771260948091" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your departure city?" name="text-1771260975298" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adults in your travel party?" name="text-1771261013524" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="How many children in your travel party? Please list Birthdates." name="textarea-1771261114896" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Where are you wanting to stay?" name="checkbox-group-1771261184642" other="true">&#13;
			<option label="Universal Helios Grand Hotel, a Loews Hotel" value="universal-helios-grand-hotel-a-loews-hotel">Universal Helios Grand Hotel, a Loews Hotel</option>&#13;
			<option label="Loews Royal Pacific Hotel" value="loews-royal-pacific-hotel">Loews Royal Pacific Hotel</option>&#13;
			<option label="Hard Rock Hotel" value="hard-rock-hotel">Hard Rock Hotel</option>&#13;
			<option label="Loews Portofino Bay Hotel" value="loews-portofino-bay-hotel">Loews Portofino Bay Hotel</option>&#13;
			<option label="Universal Stella Nova Resort" value="universal-stella-nova-resort">Universal Stella Nova Resort</option>&#13;
			<option label="Universal Terra Luna Resort" value="universal-terra-luna-resort">Universal Terra Luna Resort</option>&#13;
			<option label="Universal Adventura Hotel" value="universal-adventura-hotel">Universal Adventura Hotel</option>&#13;
			<option label="Universal Cabana Bay Beach Resort" value="universal-cabana-bay-beach-resort">Universal Cabana Bay Beach Resort</option>&#13;
			<option label="Universal Endless Summer Resort" value="universal-endless-summer-resort">Universal Endless Summer Resort</option>&#13;
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		<field type="text" required="true" label="How many days of tickets do you need?" name="text-1771261627964" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What type of ticket do you need?" name="checkbox-group-1771261699187">&#13;
			<option label="(1) Park per day" value="1-park-per-day">(1) Park per day</option>&#13;
			<option label="Park to Park (2+) parks per day" value="park-to-park-2-parks-per-day">Park to Park (2+) parks per day</option>&#13;
			<option label="Not sure" value="not-sure">Not sure</option>&#13;
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		<field type="checkbox-group" required="true" label="What parks are you wanting to go to?" name="checkbox-group-1771450682591">&#13;
			<option label="Universal EPIC Universe" value="universal-epic-universe">Universal EPIC Universe</option>&#13;
			<option label="Universal Studios Florida" value="universal-studios-florida">Universal Studios Florida</option>&#13;
			<option label="Universal Islands of Adventure" value="universal-islands-of-adventure">Universal Islands of Adventure</option>&#13;
			<option label="Universal Volcano Bay" value="universal-volcano-bay">Universal Volcano Bay</option>&#13;
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		<field type="text" required="true" label="Do you want Express passes?" name="text-1771262120437" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are you interested in any VIP experiences?" name="text-1771262162845" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are you interested in a photo package?" name="text-1771262231998" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Do you need any of these other services?" name="checkbox-group-1771262308542" other="true">&#13;
			<option label="Stroller Rental" value="stroller-rental">Stroller Rental</option>&#13;
			<option label="Crib Rental" value="crib-rental">Crib Rental</option>&#13;
			<option label="Scooter Rental" value="scooter-rental">Scooter Rental</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Airport - Resort Transportation" value="airport-resort-transportation">Airport - Resort Transportation</option>&#13;
			<option label="Dining" value="dining">Dining</option>&#13;
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		<field type="text" required="true" label="Will you need trip insurance?" name="text-1771262419452" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Is there anything else you&#39;d like to tell me?&amp;nbsp;" name="textarea-1771262468104" className="form-control"/>&#13;
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