Share your information with Regina Hardin

Regina Hardin

Tribe of the Sunset Travel Adventures LLC

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		<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="Let&#39;s find the best cruise for YOU!"/>&#13;
		<field type="radio-group" label="Is this your first cruise?" name="is-this-your-first-cruise">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I'm a cruise PRO!" value="im-a-cruise-pro">I'm a cruise PRO!</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="The purpose of this cruise vacation is:" name="the-purpose-of-this-cruise-vacation-is">&#13;
			<option label="Making Memories w/ Family and/or friends" value="making-memories-w-family-andor-friends">Making Memories w/ Family and/or friends</option>&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Just For Fun!" value="just-for-fun">Just For Fun!</option>&#13;
			<option label="Relax &amp; Recharge (Spa?)" value="relax-recharge-spa">Relax &amp; Recharge (Spa?)</option>&#13;
			<option label="Celebrating a Special Occasion" value="celebrating-a-special-occasion">Celebrating a Special Occasion</option>&#13;
		</field>&#13;
		<field type="text" label="Where would you like to go? It can be a description like &quot;tropical&quot; or if there&#39;s a certain port you must visit, please share it here." placeholder="ex: Tahiti" name="preferred-destinations" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Practical Information"/>&#13;
		<field type="date" label="When would you like to depart?" name="starting-at" className="form-control"/>&#13;
		<field type="date" label="When would you like to return?" 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;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Is everyone in your party a US citizen?" description="If not  we need to know so that we can advise you properly" name="is-everyone-in-your-party-a-us-citizen" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What state do you live in?" name="what-state-do-you-live-in" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="By proceeding with travel arrangements, I acknowledge that certain destinations, tour companies, and cruise lines may require COVID-19 vaccination, and it is my responsibility to ascertain and comply with these requirements." name="by-proceeding-with-travel-arrangements-i-acknowledge-that-certain-destinations-tour-companies-and-cruise-lines-may-require-covid19-vaccination-and-it-is-my-responsibility-to-ascertain-and-comply-with-these-requirements">&#13;
			<option label="I acknowledge" value="i-acknowledge">I acknowledge</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="I understand that it is vitally important that I read the information emailed to me by my advisor in order to be prepared for travel in the current climate. I also understand that I share the responsibility of remaining informed about the entry requirements for the destination(s) I am visiting. I will secure all necessary testing and complete all forms required for travel." name="i-understand-that-it-is-vitally-important-that-i-read-the-information-emailed-to-me-by-my-advisor-in-order-to-be-prepared-for-travel-in-the-current-climate-i-also-understand-that-i-share-the-responsibility-of-remaining-informed-about-the-entry-requirements-for-the-destinations-i-am-visiting-i-will-secure-all-necessary-testing-and-complete-all-forms-required-for-travel">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
			<option label="I do not agree" value="i-do-not-agree">I do not agree</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>