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Averi Gibson

Painted Sky Vacations

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#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="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" 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="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Insurance Acknowledgment&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Emergencies can happen when you least expect them. Painted Sky Vacations highly recommends that all clients purchase a travel insurance policy to protect their investment in their travel. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. And, keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of Trip Cancellation, Trip Delay, Trip Interruption, Missed Connection, Baggage Loss, Theft or Damage, Baggage Delay, Emergency Medical and Dental Expenses, and Emergency Medical Transportation, among other unforeseen circumstances."/>&#13;
		<field type="paragraph" subtype="p" label="Please also note that in order for you to obtain coverage for certain pre-existing conditions, or for supplier default, your policy must be purchased at the time of booking or shortly thereafter (depending on the terms of the policy)."/>&#13;
		<field type="paragraph" subtype="p" label="Please understand that we are not registered insurance agents, and cannot legally provide specific advice or information regarding insurance. We will gladly secure a quote for you, upon request, and if Painted Sky Vacations does not, or is not legally able to secure coverage on your behalf, it is our strong recommendation that you purchase a policy on your own."/>&#13;
		<field type="checkbox-group" label="Travel insurance Acknowledgment" name="travel-insurance-acknowledgment">&#13;
			<option label="Yes, I want travel insurance" value="yes-i-want-travel-insurance">Yes, I want travel insurance</option>&#13;
			<option label="No, I do not want travel insurance" value="no-i-do-not-want-travel-insurance">No, I do not want travel insurance</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Painted Sky Vacations Client Agreement"/>&#13;
		<field type="paragraph" subtype="p" label="When you retain Painted Sky Vacations to help plan your travel, you&#39;re hiring a professional travel advisor to ensure that your trip is tailored to your taste, preferences, and budget. You get the benefit of our skill, experience and training, our professional relationships, and our industry connections. Our Professional Services Fee covers your consultation, our research and recommendations, preparation of quotes and itineraries, reserving and booking each element of your trip, securing quotes for comprehensive travel insurance, administration of your booking from deposit to departure, and follow-up post-trip with suppliers (as needed).&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="To read the Terms and Conditions, please visit http://paintedskyvacations.com/t-and-c."/>&#13;
		<field type="paragraph" subtype="p" label="By checking the box below and signing this form, you acknowledge that you are hiring us to plan your trip and that you have read and agree to our Terms and Conditions of booking, which are located at:&amp;nbsp;"/>&#13;
		<field type="checkbox-group" label="Client Agreement" name="checkbox-group-1769881894712">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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