<form-template>
	<fields>
		<field type="header" subtype="h2" label="Universal Theme Parks Vacation Information Request"/>
		<field type="paragraph" subtype="p" label="Thank you for your interest in planning a magical vacation to Universal Parks and Resorts! As a travel agency owner right here in Orlando, I have the expertise and experience you need to plan the vacation your kids (or you!) have been dreaming of! Please be sure to enter all names and birthdays exactly as they appear on the legal document you will be using to travel on this trip."/>
		<field type="header" subtype="h2" label="Full name"/>
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="select" label="Is this a cell phone?" name="is-this-a-cell-phone" className="form-control">
			<option label="Yes, and it's OK to text me" value="yes-and-its-ok-to-text-me" selected="true">Yes, and it's OK to text me</option>
			<option label="Yes, but please don't text me" value="yes-but-please-dont-text-me">Yes, but please don't text me</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="header" subtype="h2" label="Address"/>
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>
		<field type="textarea" required="true" label="What are the full names and birthdays of all additional travelers?&amp;nbsp;If you are traveling solo, enter N/A.&amp;nbsp;" name="notes" subtype="textarea" className="form-control"/>
		<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"/>
		<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"/>
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">
			<option label="Yes" value="yes">Yes</option>
		</field>
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>
		<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">
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>
			<option label="$10,000+" value="10000">$10,000+</option>
		</field>
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">
			<option label="Economy" value="value">Economy</option>
			<option label="Moderate" value="moderate">Moderate</option>
			<option label="Luxury" value="luxury">Luxury</option>
			<option label="Boutique" value="boutique">Boutique</option>
		</field>
		<field type="checkbox-group" label="Which of the following are you interested in?" description="Check all that apply." name="vibe-preference" other="true">
			<option label="Resort" value="resort">Resort</option>
			<option label="Park tickets" value="park-tickets">Park tickets</option>
			<option label="Airline tickets" value="airline-tickets">Airline tickets</option>
			<option label="Meal plan" value="meal-plan">Meal plan</option>
		</field>
		<field type="checkbox-group" label="Celebrations" description="Check all that apply" name="activity-preferences" other="true">
			<option label="First visit" value="first-visit">First visit</option>
			<option label="Engaged/Just married" value="engagedjust-married">Engaged/Just married</option>
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>
			<option label="Birthday" value="birthday">Birthday</option>
			<option label="Reunion" value="">Reunion</option>
			<option label="Personal triumph!" value="personal-triumph">Personal triumph!</option>
		</field>
		<field type="text" label="Does anyone in your party have any special dietary or physical needs?" name="must-dos" subtype="text" className="form-control"/>
		<field type="radio-group" required="true" label="Would you like more information about the Purple Brick Path, my customized Walt Disney World vacation planning service?&amp;nbsp;" name="would-you-like-more-information-about-the-purple-brick-path-my-customized-walt-disney-world-vacation-planning-service-">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="textarea" label="Is there anything else I should know? Enter your must-see or must-do items here, along with any questions or concerns you have." name="is-there-anything-else-i-should-know-enter-your-mustsee-or-mustdo-items-here-along-with-any-questions-or-concerns-you-have" subtype="textarea" className="form-control"/>
		<field type="paragraph" subtype="p" label="-I understand it is my responsibility to read all policies and Terms &amp;amp; Conditions, including the Cancellation Policy, Document Policy, and Airline Baggage/Seat policies.&amp;nbsp;&amp;nbsp;"/>
		<field type="paragraph" subtype="p" label="-I agree that Purple Martin Vacations will not be responsible for omissions or errors on legal names provided on this document.&amp;nbsp;&amp;nbsp;"/>
		<field type="paragraph" subtype="p" label="-I understand that quotes are not guarantees of availability or pricing until a deposit is paid. Payment must be received by the due date to avoid vendor cancellation.&amp;nbsp;"/>
		<field type="paragraph" subtype="p" label="-I understand that Purple Martin Vacations will provide two vacation quotes for free. Additional quotes will require a research fee of $20 per family/room."/>
		<field type="checkbox-group" required="true" label="Let's do this!" name="i-understand-it-is-my-responsibility-to-read-all-policies-and-terms-conditions-including-the-cancellation-policy-document-policy-travel-insurance-recommendation-and-airline-baggageseat-policies-i-agree-that-purple-martin-vacations-will-not-be-responsible-for-omissions-or-errors-on-legal-names-provided-on-this-document-i-understand-that-all-quotes-are-not-guarantees-of-availability-or-pricing-until-a-deposit-is-paid-payment-must-be-received-by-the-due-date-to-avoid-vendor-cancellation-i-understand-that-purple-martin-vacations-will-provide-two-vacation-quotes-for-free-additional-quotes-will-require-a-research-fee-of-20-per-familyroom">
			<option label="I agree!" value="i-agree">I agree!</option>
		</field>
	</fields>
</form-template>