Share your information with Precious Campbell

Precious Campbell

Precious Memories & Getaways

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="PRE-DEPARTURE TRAVEL PROTECTION WAIVER"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for choosing to travel with Precious Memories &amp;amp; Getaways. I value your business and appreciate you allowing me to plan your dream vacation.&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="By law I am required to offer you pre-departure travel protection. For this reason I require that all of my clients who wish to waive the travel protection that was offered complete, sign and submit this Pre-Departure Travel&amp;nbsp;Protection Waiver indicating that you have been offered travel protection and chose not to purchase and will accept all responsibility.&amp;nbsp;&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Emergencies can happen when you least expect it. &amp;nbsp;I highly recommend that you protect your vacation with pre-departure travel insurance.&amp;nbsp;&amp;nbsp;The cruise lines, airlines, hotels and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. By waiving the pre-departure travel insurance, your trip is NON-REFUNDABLE if canceled."/>&#13;
		<field type="checkbox-group" required="true" label="Please acknowledge:" name="please-acknowledge" className="checkbox-group">&#13;
			<option label="YES, I accept all the financial responsibilities of my trip and I am aware that my trip is NON-REFUNDABLE if canceled." value="YES, I accept all the financial responsibilities of my trip and I am aware that my trip is NON-REFUNDABLE if canceled.">YES, I accept all the financial responsibilities of my trip and I am aware that my trip is NON-REFUNDABLE if canceled.</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="First name" placeholder="First" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" placeholder="Last" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" subtype="email" required="true" label="Email" name="email" className="form-control"/>&#13;
		<field type="text" subtype="tel" required="true" label="Phone" name="phone-number" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="I have been advised of, and understand the benefits of Pre-Departure Travel Protection. Since I have decided to decline this protection, I understand that I will assume all financial responsibility for any expenses incurred as a result of being unable to travel.&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="By signing below you are again ackowledging that you do not want to purchase the Pre-Departure Travel Protection, and assume all responsibility."/>&#13;
		<field type="paragraph" subtype="p" label="You are also acknowledging that you will not take any legal action, defame and or negatively attack Precious Memories &amp;amp; Getaways because of loss of funds due to waiving the Pre-Departure Travel Protection."/>&#13;
		<field type="paragraph" subtype="p" label="Please understand that your booking can not be processed before you have completed and submitted this form."/>&#13;
		<field type="checkbox-group" required="true" label="By entering my full name and submitting this form, I acknowledge that this serves as my electronic signature. I confirm that I have read, understood, and agree to the terms outlined above." name="checkbox-group-1774734362044">&#13;
			<option label="I AGREE" value="i-agree">I AGREE</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Full Legal Name (Electronic Signature)" name="text-1774734519554" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date Signed" name="date-1774734627543" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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