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Virginia Moore

Virginia Moore Travel

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Welcome to our Paris &amp;amp; Loire Valley 2026 registration!"/>&#13;
		<field type="paragraph" subtype="p" label="Filling out this form submits a request to confirm your spot. Once received, we will follow up with an email containing the deposit invoice and booking agreement to secure your place."/>&#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 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="Allergies&amp;nbsp;" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Kindly note that this trip is priced at double occupancy. Please indicate below who your roommate will be. If you are traveling solo, we will contact you regarding the supplemental cost for a single room. If you have any other special requirements, please let us know!"/>&#13;
		<field type="text" required="true" label="Who will you be coming with (name and connection)? If you’re coming solo, please let me know.&amp;nbsp;" name="who-will-you-be-coming-with-name-and-connection-if-youre-coming-solo-please-let-me-know-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Where are you flying from?&amp;nbsp;" name="where-are-you-flying-from-" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="The total cost of the trip is $6,000 per person based on double occupancy. All payments are non-refundable. We will provide flexible payment plan options for your convenience. Please note that your spot is not confirmed until the deposit has been received."/>&#13;
		<field type="paragraph" subtype="p" label="We strongly recommend purchasing “Cancel For Any Reason” travel insurance for maximum protection. On-trip travel insurance is required for all participants, and I can help you navigate coverage options."/>&#13;
		<field type="paragraph" subtype="p" label="Payments may be made via Venmo, Zelle, check, or credit card. Please note, as a small business, a 3% processing fee will be added to all credit card transactions."/>&#13;
	</fields>&#13;
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