Share your information with Randall Beckett

Randall Beckett

Bethany Tours

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		<field type="header" subtype="h1" label="Cape Peninsula Tour - Inquiry Form"/>&#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 (As shown on passport)" 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" 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="radio-group" label="What is your gender?" name="what-is-your-gender">&#13;
			<option label="Male" value="male">Male</option>&#13;
			<option label="Female" value="female">Female</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Inquiry Date&amp;nbsp;" name="date-1753442335188" className="form-control"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel details"/>&#13;
		<field type="text" required="true" label="What is your departure city?" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure date" name="departure-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Return Date" name="return-date" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="how-many-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adults? (18 and older)" name="how-many-adults-18-and-older" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children and their age?" name="how-many-children-and-their-age" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Do you need airport transfer to and from your booked accommodation?" name="airport-transfer-to-and-from-accommodation-required-" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Select your places of interest&amp;nbsp; or any activities to help us customize a memorable itinerary for your full day Cape Peninsula Tour." name="select-your-places-of-interest-or-any-activities-for-your-full-day-8hrs-cape-town-city-tour" other="true">&#13;
			<option label="Signal Hill - View of the City " value="signal-hill-view-of-the-city-">Signal Hill - View of the City </option>&#13;
			<option label="Kirstenbosch Botanical Gardens " value="kirstenbosch-botanical-gardens-">Kirstenbosch Botanical Gardens </option>&#13;
			<option label="Groot Constantia Wine Estate " value="groot-constantia-wine-estate-">Groot Constantia Wine Estate </option>&#13;
			<option label="Muizenberg Beach  " value="muizenberg-beach-">Muizenberg Beach  </option>&#13;
			<option label="Kalk Bay Harbour" value="kalk-bay-harbour">Kalk Bay Harbour</option>&#13;
			<option label="Simons Town " value="simons-town-">Simons Town </option>&#13;
			<option label="Boulders Beach - Cape Penguins" value="boulders-beach-cape-penguins">Boulders Beach - Cape Penguins</option>&#13;
			<option label="Cape Point Light House and  Cape of Good Hope " value="cape-point-light-house-and-cape-of-good-hope-">Cape Point Light House and  Cape of Good Hope </option>&#13;
			<option label="Cape Point to Cape of Good Hope Hike " value="cape-point-to-cape-of-good-hope-hike-">Cape Point to Cape of Good Hope Hike </option>&#13;
			<option label="Chapmans Peak Drive  " value="chapmans-peak-drive-">Chapmans Peak Drive  </option>&#13;
			<option label="Hout Bay " value="hout-bay-">Hout Bay </option>&#13;
			<option label="Camps Bay / Sea Point Promenade " value="camps-bay-sea-point-promenade-">Camps Bay / Sea Point Promenade </option>&#13;
			<option label="Foodie Activities in Cape Town" value="foodie-activities-in-cape-town">Foodie Activities in Cape Town</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Walks /  Short Hikes" value="walks-short-hikes">Walks /  Short Hikes</option>&#13;
			<option label="Horseback Riding" value="horseback-riding">Horseback Riding</option>&#13;
			<option label="Kayaking" value="kayaking">Kayaking</option>&#13;
			<option label="Surfing" value="surfing">Surfing</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="checkbox-group" label="Vibe preferences" 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="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;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
	</fields>&#13;
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  </body>
</html>