www.ewmevents.com.au Open in urlscan Pro
40.126.238.41  Public Scan

URL: https://www.ewmevents.com.au/wellaredforum2024/staff/Site/Register
Submission: On February 02 via manual from IN — Scanned from AU

Form analysis 18 forms found in the DOM

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="11d8d8a3-450f-60e6-55f8-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Html.HtmlComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="0"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div>
    <h3><strong>STAFF REGISTRATION</strong></h3>
    <p>Welcome to the staff registration form for the Wella RED Forum 2024 to be held in Dubrovnik, Croatia from Sunday 15 - Friday 20 September 2024.</p>
    <p>Please see below information about the upcoming Forum and important information in order to complete your registration. Should you have any queries whilst completing the form, please contact the Wella Red Event Team directly on
      <a href="mailto:wellared@ewm.com.au">wellared@ewm.com.au</a><a href="mailto:wellared@ewm.com.au">.</a></p>
    <h3><strong>ACCOMMODATION</strong></h3>
    <p>Prior to commencing the registration, p<span>lease confirm with Matt or Julie what day you will need to arrive in Dubrovnik</span>, as you will need to select your check in date to secure your accommodation and proceed through the registration
      process.</p>
    <h3><strong>MAIN EVENT DATES</strong></h3>
    <p>Sunday 15 - Friday 20 September 2024</p>
    <h3><strong>VENUE</strong></h3>
    <p><a href="https://www.dubrovniksungardens.com" target="_blank" rel="noopener">Sun Gardens Hotel</a>, Dubrovnik</p>
    <h3><strong>CONTACT</strong></h3>
    <p>Wella Red Event Team<br>Email: <a href="mailto:wellared@ewm.com.au" target="_blank" rel="noopener">wellared@ewm.com.au</a><br>Phone: +61 459 349 932</p>
    <p>&nbsp;</p>
    <p>Please select 'Wella Staff' to complete your registration.</p>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="1bf3fed7-4a32-4bfb-9469-0030bc6a843f"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.RegistrationType.RegistrationTypeComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="1"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <input id="f8842fb8-552b-4eac-ae5f-24359ca5507b_AddToWaitList" name="f8842fb8-552b-4eac-ae5f-24359ca5507b_AddToWaitList" type="hidden" value="false">
  <div class="radio form-group row has-feedback">
    <div class="col-xs-5" style="">
      <strong><input class="inv-aware" data-inputtype="RadioGroup1_RegistrationType" data-inv-key="f8842fb8-552b-4eac-ae5f-24359ca5507b" data-inv-payment-status="Inclusive" data-inv-quantity="1" data-inv-type="Registration" data-togglevisibility=""
          data-used-by-discount="Registration" id="f8842fb8-552b-4eac-ae5f-24359ca5507b" name="f8842fb8-552b-4eac-ae5f-24359ca5507b" type="radio" value=""></strong>
      <label for="f8842fb8-552b-4eac-ae5f-24359ca5507b">
        <strong> Wella Staff <span style="display:none" class="label exhausted_label label-primary">FULL</span>
        </strong>
      </label>
    </div>
  </div>
  <input type="hidden" name="f8842fb8-552b-4eac-ae5f-24359ca5507b_DiscountCodeKey" id="f8842fb8-552b-4eac-ae5f-24359ca5507b_DiscountCodeKey" class="form-control inv-aware" data-inv-type="DiscountCode"
    data-inv-referenceid="f8842fb8-552b-4eac-ae5f-24359ca5507b" data-inv-payment-status="Inclusive">
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="ca389e34-3d90-25f0-f1c3-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.PageBreak.PageBreakComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="2"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #c15baa96-3ea0-4f55-83e3-9ec97478d881 .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="9b0484d2-74d6-4ca6-ac92-bb8e92805a33">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward" style="display: none;">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#c15baa96-3ea0-4f55-83e3-9ec97478d881" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn page-forward">Next</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="089c16f0-f186-9585-9c6e-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Contact.ContactComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="3"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="text-left h3">
    <b>CONTACT DETAILS</b>
  </div>
  <div class="row no-theme">
    <div class="col-xs-12">
      <p>Please complete all details below as per your photo identification or passport to ensure all future travel bookings are made correctly.</p>
      <p>If you need to change any of the below information, please contact the Wella Red Event Team on <a href="mailto:wellared@ewm.com.au">wellared@ewm.com.au.</a></p>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_Title" id="089c16f0-f186-9585-9c6e-3a106a229111_Title_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">Title</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <select class="form-control select2-hidden-accessible" id="089c16f0-f186-9585-9c6e-3a106a229111_Title" name="Title" required="" aria-required="true" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111" tabindex="-1" aria-hidden="true" title="">
        <option></option>
        <option>Mr</option>
        <option>Miss</option>
        <option>Mrs</option>
        <option>Ms</option>
        <option>Mx</option>
      </select><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr" style="display: block;"><span class="selection"><span class="select2-selection select2-selection--single ignore-validation form-control"
            aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="089c16f0-f186-9585-9c6e-3a106a229111_Title_label" data-select2-focus="089c16f0-f186-9585-9c6e-3a106a229111_Title"
            aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111" role="combobox"><span class="select2-selection__rendered" id="select2-089c16f0-f186-9585-9c6e-3a106a229111_Title-container" role="textbox" aria-readonly="true"><span
                class="select2-selection__placeholder"> </span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_FirstName" id="089c16f0-f186-9585-9c6e-3a106a229111_FirstName_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">First name</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_FirstName" name="FirstName" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_MiddleName" id="089c16f0-f186-9585-9c6e-3a106a229111_MiddleName_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111">Middle Name</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_MiddleName" name="MiddleName" value="" data-titlecased="" data-autosaved="&quot;false&quot;" aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_LastName" id="089c16f0-f186-9585-9c6e-3a106a229111_LastName_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">Last name</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_LastName" name="LastName" value="" required="" aria-required="true" data-titlecased="" maxlength="60" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_Organization" id="089c16f0-f186-9585-9c6e-3a106a229111_Organization_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">Organization</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_Organization" name="Organization" value="Wella" required="" aria-required="true" data-titlecased="" maxlength="120" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_Position" id="089c16f0-f186-9585-9c6e-3a106a229111_Position_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">Job title</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_Position" name="Position" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_EmailAddress" class="field-required">Email address</label>
    </div>
    <div class="col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_EmailAddress" name="EmailAddress" value="" data-rule-required="true" required="" aria-required="true"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="089c16f0-f186-9585-9c6e-3a106a229111_MobileNumber" id="089c16f0-f186-9585-9c6e-3a106a229111_MobileNumber_label" data-description-id="anchor_0e51c32c-5104-561f-9c61-3a106a229111" class="field-required">Mobile</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="089c16f0-f186-9585-9c6e-3a106a229111_MobileNumber" name="MobileNumber" value="" required="" aria-required="true" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_0e51c32c-5104-561f-9c61-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="8e4cbfb6-8786-0c25-acb4-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.PageBreak.PageBreakComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="4"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #1ed34d3b-3e5e-4b6f-af70-806293ae3a04 .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="e261ee78-8f93-41df-b8a0-8f6ebd3451cc">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#1ed34d3b-3e5e-4b6f-af70-806293ae3a04" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn page-forward">Next</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="30cf39ad-e948-d0e4-10ae-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Contact.ContactComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="5"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" class="text-left h3">
    <b>HOME ADDRESS</b>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressLineOne" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressLineOne_label" data-description-id="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" class="field-required">Street Address</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressLineOne" name="AddressLineOne" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCity" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCity_label" data-description-id="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" class="field-required">Suburb</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCity" name="AddressCity" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressState" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressState_label" class="field-required-theme">State</label>
    </div>
    <div class="col-sm-9">
      <input type="hidden" id="AddressState_data" value="/wellaredforum2024/staff/ContactComponent/States">
      <input type="hidden" id="AddressState_value">
      <input type="text" class="form-control classicTheme theme-textbox" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressState" name="AddressState" required="" aria-required="true" value="" data-titlecased="" data-state=""
        data-parentid="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry" data-nice-sort="true" aria-describedby="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111">
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressPostcode" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressPostcode_label" data-description-id="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" class="field-required">Postcode</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressPostcode" name="AddressPostcode" value="" required="" aria-required="true" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry_label" data-description-id="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" class="field-required">Country</label>
    </div>
    <div class="col-sm-9">
      <input type="hidden" id="AddressCountry_data" value="/wellaredforum2024/staff/ContactComponent/Countries">
      <input type="hidden" id="AddressCountry_value">
      <input type="text" class="form-control classic-select select2-hidden-accessible" id="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry" name="AddressCountry" required="" aria-required="true" value="" data-titlecased="" data-country=""
        data-nice-sort="false" tabindex="-1" aria-hidden="true"><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr"><span class="selection"><span
            class="select2-selection select2-selection--single ignore-validation" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry_label"
            data-select2-focus="30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry" aria-describedby="anchor_4bb766f6-dfc7-f3ed-1fe4-3a106a229111" role="combobox"><span class="select2-selection__rendered"
              id="select2-30cf39ad-e948-d0e4-10ae-3a106a229111_AddressCountry-container" role="textbox" aria-readonly="true"></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span
          class="dropdown-wrapper" aria-hidden="true"></span></span>
    </div>
  </div>
  <div id="anchor_3c72399b-69e1-304e-4b32-3a106a229111" class="text-left h3">
    <b>NAME BADGE</b>
  </div>
  <div class="text-left">
    <p> Please advise your preferred name for reference during the event. </p>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredFirstName" id="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredFirstName_label" data-description-id="anchor_3c72399b-69e1-304e-4b32-3a106a229111" class="field-required">Preferred First
        Name</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredFirstName" name="PreferredFirstName" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_3c72399b-69e1-304e-4b32-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredLastName" id="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredLastName_label" data-description-id="anchor_3c72399b-69e1-304e-4b32-3a106a229111" class="field-required">Preferred Last
        Name</label>
    </div>
    <div class="col-xs-12 col-sm-9">
      <input type="text" class="form-control" id="30cf39ad-e948-d0e4-10ae-3a106a229111_PreferredLastName" name="PreferredLastName" value="" required="" aria-required="true" data-titlecased="" data-autosaved="&quot;false&quot;"
        aria-describedby="anchor_3c72399b-69e1-304e-4b32-3a106a229111">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div id="anchor_591a1ca5-1b09-b23c-3a67-3a106a229111" class="text-left h3">
    <b>EMERGENCY CONTACT DETAILS</b>
  </div>
  <div class="text-left">
    <p> In the case of an emergency please advise who we should contact. Please provide a contact of someone not travelling with you. </p>
  </div>
  <div class="row form-group has-feedback cstField" id="74abc2db-86a4-42b1-a95c-bd202ab0cb2e_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_65a9011bd1473818c4783a0e906a2e09" class="field-required">Full Name</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input aria-required="true" class="form-control" id="cst_65a9011bd1473818c4783a0e906a2e09" name="cst_65a9011bd1473818c4783a0e906a2e09" required="" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="2b77991f-c30d-4362-af0f-e4f5b74f3c45_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_9ce0021358380e695aa93a0e906a2d3e" class="field-required">Phone Number</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input aria-required="true" class="form-control" id="cst_9ce0021358380e695aa93a0e906a2d3e" name="cst_9ce0021358380e695aa93a0e906a2d3e" required="" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="39a18c6c-b99b-4f7c-875f-a853945231ea_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_52428f01ef83b9b957873a0e906a2cb1" class="field-required">Relationship</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input aria-required="true" class="form-control" id="cst_52428f01ef83b9b957873a0e906a2cb1" name="cst_52428f01ef83b9b957873a0e906a2cb1" required="" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div id="anchor_5f28f968-30d7-5239-e1df-3a106a229111" class="text-left h3">
    <b>DIETARY AND MEDICAL REQUIREMENTS</b>
  </div>
  <div class="text-left">
    <p> Your dietary and medical requirements are kept confidential, and only provided to third parties whom are required to be informed in order to support you in your request.<br><br>Please select your dietary requirement from the drop down list
      below; if you do not have a dietary requirement, please leave <i>blank.</i>
    </p>
  </div>
  <div class="row form-group has-feedback">
    <div class="col-sm-3">
      <label for="DietaryId" id="DietaryId_label" data-description-id="anchor_5f28f968-30d7-5239-e1df-3a106a229111">Dietary Requirements</label>
    </div>
    <div class="col-sm-9">
      <select class="select2-container select2-allowclear select2-hidden-accessible" data-dietary="True" data-input-type="dropdown" data-label="Dietary Requirements" data-selected="" id="DietaryId" multiple="" name="DietaryId" tabindex="-1"
        aria-hidden="true" title="">
        <option value="854bda4b-254c-4612-8ec1-8eb18f53ef42"></option>
        <option value="dae97190-449e-4d50-88a1-8ab0c65d4fd4">Coeliac</option>
        <option value="c34ec20e-5d97-45df-abfb-1907da1caae5">Dairy free</option>
        <option value="596a4293-c9c8-4fd5-9ba6-7a6b15bc411b">Diabetic</option>
        <option value="64ca438c-2075-4bad-84b0-19644ce16d72">Egg free</option>
        <option value="d8309be3-dba1-481f-92dd-efaa3db5dd8b">Gluten free/coeliac</option>
        <option value="9c6b2395-bba0-49dc-99c8-663782279798">Halal</option>
        <option value="02d1694a-2b64-475f-bd55-c793bb853ab1">Kosher</option>
        <option value="f67e8064-efd3-493a-8616-52d2d8c3771f">Lacto-Vegetarian</option>
        <option value="d6a50fd7-84aa-493a-abb6-7b5b18963fd5">No beef</option>
        <option value="f9c8deb2-307b-48d3-b404-9b1de65886ad">No pork</option>
        <option value="55214f3b-eb50-445d-9c94-000c6ad3c8e0">No seafood</option>
        <option value="04b336f8-ad63-47ed-a400-c4678ea20c87">Nut allergy</option>
        <option value="ec5e2891-dabd-460c-9b9c-0f2dd92de473">Other (please specify)</option>
        <option value="59d6632f-e571-4f3b-8f14-4eae31f57aa6">Ovo-Vegetarian</option>
        <option value="d982fa1a-a7d2-478c-97ee-2f84d3aed956">Pescatarian</option>
        <option value="4b974f0c-4985-4650-84bd-86389107ed30">Pescetarian</option>
        <option value="63f4dd4e-08fa-47ab-96e4-b8caf261e524">Seafood allergy</option>
        <option value="fcc91966-7c7c-48bf-9ec2-86c24fc61906">Seafood and nut allergy</option>
        <option value="3bea3e28-3969-4bb2-ae19-2c621b4d14d8">Shellfish allergy</option>
        <option value="da34f7b1-c8f5-4dc3-b7a7-544796629ead">Soy allergy</option>
        <option value="45ac112a-9b72-4bb0-9b55-ebc0d18d1051">Vegan</option>
        <option value="783b6ac7-8cb2-4b14-9eea-f0d0c094de22">Vegetarian</option>
        <option value="478c3c42-30cd-41a9-a98c-2aa28d055718">Wheat free</option>
        <option value="DietaryOther">Other</option>
      </select><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr" style="display: block;"><span class="selection"><span class="select2-selection select2-selection--multiple ignore-validation form-control"
            aria-haspopup="true" aria-expanded="false" tabindex="-1">
            <ul class="select2-selection__rendered" aria-live="polite" aria-relevant="additions removals" aria-atomic="true">
              <li class="select2-search select2-search--inline"><input class="select2-search__field" type="text" tabindex="0" autocomplete="off" autocorrect="off" autocapitalize="none" spellcheck="false" role="textbox" aria-autocomplete="list"
                  placeholder=" " style="width: 0px;"></li>
            </ul>
          </span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
    </div>
  </div>
  <div class="row form-group has-feedback" id="dietaryOtherDiv" style="display:none">
    <div class="col-sm-3">
      <label for="DietaryOther" class="field-required">Other</label>
    </div>
    <div class="col-sm-9">
      <input type="text" class="form-control" id="DietaryOther" name="DietaryOther" value="" required="" aria-required="true">
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="9b8960ec-ef87-45e6-b5a7-1084c12b2cdc_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_81aa319c0e9f99e494b63a0e906a2cff">Medical Condition</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input class="form-control" id="cst_81aa319c0e9f99e494b63a0e906a2cff" name="cst_81aa319c0e9f99e494b63a0e906a2cff" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="text-left">
    <p> Please advise if you require any mobility or accessibility assistance. </p>
  </div>
  <div class="row form-group has-feedback cstField" id="df027d81-7683-43c2-9ef2-d49703fc314e_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_093638ab14f1b0ca48373a0e906a2cf0">Mobility / Accessibility Assistance</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input class="form-control" id="cst_093638ab14f1b0ca48373a0e906a2cf0" name="cst_093638ab14f1b0ca48373a0e906a2cf0" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div id="anchor_45be7af7-12ee-6f27-9226-3a106a229111" class="text-left h3">
    <b>PASSPORT DETAILS</b>
  </div>
  <div class="text-left">
    <p> It is a requirement by the Croatian Government that the following details are recorded by the hotel. If you do not have a passport or it will be expired by the time of travel, please leave this blank and EWM will follow up with you at a later
      time. </p>
  </div>
  <div class="row form-group has-feedback cstField" id="aeffd20a-c78b-434c-afc6-9426c44f8ef1_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_6f4637725f342a6945e43a0e906a2dda">Passport Number</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input class="form-control" id="cst_6f4637725f342a6945e43a0e906a2dda" name="cst_6f4637725f342a6945e43a0e906a2dda" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="f963ee22-c341-4b4a-b70e-05ebeb176a2e_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_c19f6e43a816e85981dd3a0e906a2d5d">Passport Expiry Date</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <div class="input-group input-group-form-control-addon">
        <input accessibility="true" class="form-control icon-calendar" id="cst_c19f6e43a816e85981dd3a0e906a2d5d" name="cst_c19f6e43a816e85981dd3a0e906a2d5d" type="text" value="" data-type="date" aria-autocomplete="none" placeholder="yyyy-mm-dd"
          style="min-width: 7em;"><a class="datepicker-button bootstrap3 input-group-addon bootstrap" role="button" aria-haspopup="true" tabindex="0" aria-labelledby="datepicker-bn-open-label-cst_c19f6e43a816e85981dd3a0e906a2d5d">	<span class="glyphicon glyphicon-calendar" title="Select date ..."></span></a>
      </div>
      <div class="datepicker-calendar bootstrap3 bootstrap" id="datepicker-calendar-cst_c19f6e43a816e85981dd3a0e906a2d5d" aria-hidden="true" aria-controls="cst_c19f6e43a816e85981dd3a0e906a2d5d" style="left: 0px; display: none;">
        <div class="datepicker-month-wrap">
          <div class="datepicker-button datepicker-month-fast-next pull-right" role="button" aria-labelledby="datepicker-bn-fast-next-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" tabindex="0"><span class="glyphicon glyphicon-forward"></span></div>
          <div class="datepicker-button datepicker-month-next pull-right" role="button" aria-labelledby="datepicker-bn-next-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" tabindex="0"><span class="fa fa-caret-right" style="font-size: 20px;"></span>
          </div>
          <div class="datepicker-button datepicker-month-fast-prev pull-left" role="button" aria-labelledby="datepicker-bn-fast-prev-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" tabindex="0"><span class="glyphicon glyphicon-backward"></span></div>
          <div class="datepicker-button datepicker-month-prev pull-left" role="button" aria-labelledby="datepicker-bn-prev-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" tabindex="0"><span class="fa fa-caret-left" style="font-size: 20px;"></span></div>
          <div id="datepicker-month-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-button datepicker-month" tabindex="0" role="heading" aria-live="assertive" aria-atomic="true"
            title="Click or press the Enter key or the spacebar to change the month">July 2015</div>
        </div>
        <table class="datepicker-grid" role="grid" aria-readonly="true" aria-activedescendant="datepicker-err-msg-cst_c19f6e43a816e85981dd3a0e906a2d5d" aria-labelledby="datepicker-month-cst_c19f6e43a816e85981dd3a0e906a2d5d" tabindex="0">
          <thead role="presentation">
            <tr class="datepicker-weekdays" role="row">
              <th scope="col" id="day0-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Sunday"><abbr title="Sunday">Su</abbr></th>
              <th scope="col" id="day1-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Monday"><abbr title="Monday">Mo</abbr></th>
              <th scope="col" id="day2-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Tuesday"><abbr title="Tuesday">Tu</abbr></th>
              <th scope="col" id="day3-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Wednesday"><abbr title="Wednesday">We</abbr></th>
              <th scope="col" id="day4-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Thursday"><abbr title="Thursday">Th</abbr></th>
              <th scope="col" id="day5-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Friday"><abbr title="Friday">Fr</abbr></th>
              <th scope="col" id="day6-header-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-day" role="columnheader" aria-label="Saturday"><abbr title="Saturday">Sa</abbr></th>
            </tr>
          </thead>
          <tbody role="presentation">
            <tr>
              <td id="datepicker-err-msg-cst_c19f6e43a816e85981dd3a0e906a2d5d" colspan="7">Javascript must be enabled</td>
            </tr>
          </tbody>
        </table>
        <div class="datepicker-close-wrap" aria-hidden="true" style="display: none;"> <button class="datepicker-button datepicker-close" id="datepicker-close-cst_c19f6e43a816e85981dd3a0e906a2d5d"
            aria-labelledby="datepicker-bn-close-label-cst_c19f6e43a816e85981dd3a0e906a2d5d">Close</button> </div>
        <div id="datepicker-bn-open-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-open-label offscreen">Click or press the Enter key or the spacebar to open the calendar</div>
        <div id="datepicker-bn-prev-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-prev-label offscreen">Go to previous month</div>
        <div id="datepicker-bn-next-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-next-label offscreen">Go to next month</div>
        <div id="datepicker-bn-fast-prev-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-fast-prev-label offscreen">Go to previous year</div>
        <div id="datepicker-bn-fast-next-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-fast-next-label offscreen">Go to next year</div>
        <div id="datepicker-bn-close-label-cst_c19f6e43a816e85981dd3a0e906a2d5d" class="datepicker-bn-close-label offscreen" aria-hidden="true" style="display: none;">Close the date picker</div>
      </div>
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="af19ad12-b6cf-419f-a380-d46c8d40a8eb_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_2b9bba65ecc0fcefed8d3a0e906a2e19">Passport Country</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <input class="form-control" id="cst_2b9bba65ecc0fcefed8d3a0e906a2e19" name="cst_2b9bba65ecc0fcefed8d3a0e906a2e19" type="text" value="">
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
  <div class="row form-group has-feedback cstField" id="76815f2c-067e-401a-8709-6783ad679b97_div">
    <div class="col-sm-3">
      <strong>
        <label for="cst_5b109e915af6821661103a0e906a2d3e" class="field-required">Date of Birth</label>
      </strong>
    </div>
    <div class="col-sm-9">
      <div class="input-group input-group-form-control-addon">
        <input accessibility="true" aria-required="true" class="form-control icon-calendar" id="cst_5b109e915af6821661103a0e906a2d3e" name="cst_5b109e915af6821661103a0e906a2d3e" required="" type="text" value="" data-type="date"
          aria-autocomplete="none" placeholder="yyyy-mm-dd"
          style="min-width: 7em;"><a class="datepicker-button bootstrap3 input-group-addon bootstrap" role="button" aria-haspopup="true" tabindex="0" aria-labelledby="datepicker-bn-open-label-cst_5b109e915af6821661103a0e906a2d3e">	<span class="glyphicon glyphicon-calendar" title="Select date ..."></span></a>
      </div>
      <div class="datepicker-calendar bootstrap3 bootstrap" id="datepicker-calendar-cst_5b109e915af6821661103a0e906a2d3e" aria-hidden="true" aria-controls="cst_5b109e915af6821661103a0e906a2d3e" style="left: 0px; display: none;">
        <div class="datepicker-month-wrap">
          <div class="datepicker-button datepicker-month-fast-next pull-right" role="button" aria-labelledby="datepicker-bn-fast-next-label-cst_5b109e915af6821661103a0e906a2d3e" tabindex="0"><span class="glyphicon glyphicon-forward"></span></div>
          <div class="datepicker-button datepicker-month-next pull-right" role="button" aria-labelledby="datepicker-bn-next-label-cst_5b109e915af6821661103a0e906a2d3e" tabindex="0"><span class="fa fa-caret-right" style="font-size: 20px;"></span>
          </div>
          <div class="datepicker-button datepicker-month-fast-prev pull-left" role="button" aria-labelledby="datepicker-bn-fast-prev-label-cst_5b109e915af6821661103a0e906a2d3e" tabindex="0"><span class="glyphicon glyphicon-backward"></span></div>
          <div class="datepicker-button datepicker-month-prev pull-left" role="button" aria-labelledby="datepicker-bn-prev-label-cst_5b109e915af6821661103a0e906a2d3e" tabindex="0"><span class="fa fa-caret-left" style="font-size: 20px;"></span></div>
          <div id="datepicker-month-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-button datepicker-month" tabindex="0" role="heading" aria-live="assertive" aria-atomic="true"
            title="Click or press the Enter key or the spacebar to change the month">July 2015</div>
        </div>
        <table class="datepicker-grid" role="grid" aria-readonly="true" aria-activedescendant="datepicker-err-msg-cst_5b109e915af6821661103a0e906a2d3e" aria-labelledby="datepicker-month-cst_5b109e915af6821661103a0e906a2d3e" tabindex="0">
          <thead role="presentation">
            <tr class="datepicker-weekdays" role="row">
              <th scope="col" id="day0-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Sunday"><abbr title="Sunday">Su</abbr></th>
              <th scope="col" id="day1-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Monday"><abbr title="Monday">Mo</abbr></th>
              <th scope="col" id="day2-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Tuesday"><abbr title="Tuesday">Tu</abbr></th>
              <th scope="col" id="day3-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Wednesday"><abbr title="Wednesday">We</abbr></th>
              <th scope="col" id="day4-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Thursday"><abbr title="Thursday">Th</abbr></th>
              <th scope="col" id="day5-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Friday"><abbr title="Friday">Fr</abbr></th>
              <th scope="col" id="day6-header-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-day" role="columnheader" aria-label="Saturday"><abbr title="Saturday">Sa</abbr></th>
            </tr>
          </thead>
          <tbody role="presentation">
            <tr>
              <td id="datepicker-err-msg-cst_5b109e915af6821661103a0e906a2d3e" colspan="7">Javascript must be enabled</td>
            </tr>
          </tbody>
        </table>
        <div class="datepicker-close-wrap" aria-hidden="true" style="display: none;"> <button class="datepicker-button datepicker-close" id="datepicker-close-cst_5b109e915af6821661103a0e906a2d3e"
            aria-labelledby="datepicker-bn-close-label-cst_5b109e915af6821661103a0e906a2d3e">Close</button> </div>
        <div id="datepicker-bn-open-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-open-label offscreen">Click or press the Enter key or the spacebar to open the calendar</div>
        <div id="datepicker-bn-prev-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-prev-label offscreen">Go to previous month</div>
        <div id="datepicker-bn-next-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-next-label offscreen">Go to next month</div>
        <div id="datepicker-bn-fast-prev-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-fast-prev-label offscreen">Go to previous year</div>
        <div id="datepicker-bn-fast-next-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-fast-next-label offscreen">Go to next year</div>
        <div id="datepicker-bn-close-label-cst_5b109e915af6821661103a0e906a2d3e" class="datepicker-bn-close-label offscreen" aria-hidden="true" style="display: none;">Close the date picker</div>
      </div>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="8bdbdbc1-a938-63f7-b3d2-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Marketing.MarketingComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="6"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div class="row form-group has-feedback bottom-padding-10">
    <div class="col-sm-3">
      <label for="20ab5fd6-3bcd-463b-8830-2611dd6c2b09" class="field-required">Country of Citizenship</label>
    </div>
    <div class="col-sm-9">
      <textarea aria-required="true" class="form-control" cols="20" data-togglevisibility="" id="20ab5fd6-3bcd-463b-8830-2611dd6c2b09" name="20ab5fd6-3bcd-463b-8830-2611dd6c2b09" required="" rows="2"></textarea>
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="f77d563c-4518-e302-6893-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Marketing.MarketingComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="7"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div class="row form-group has-feedback bottom-padding-10">
    <div class="col-sm-3">
      <label for="cebef86d-619f-4efe-9367-7516e0b4c7e9" class="field-required">Country of Birth</label>
    </div>
    <div class="col-sm-9">
      <textarea aria-required="true" class="form-control" cols="20" data-togglevisibility="" id="cebef86d-619f-4efe-9367-7516e0b4c7e9" name="cebef86d-619f-4efe-9367-7516e0b4c7e9" required="" rows="2"></textarea>
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="379aef38-62a3-2029-4c20-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Marketing.MarketingComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="8"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div class="row form-group has-feedback bottom-padding-10">
    <div class="col-sm-3">
      <label for="a901844b-94e6-4464-8485-bf8e76b365d5" class="field-required">City of Birth</label>
    </div>
    <div class="col-sm-9">
      <textarea aria-required="true" class="form-control" cols="20" data-togglevisibility="" id="a901844b-94e6-4464-8485-bf8e76b365d5" name="a901844b-94e6-4464-8485-bf8e76b365d5" required="" rows="2"></textarea>
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="87c61080-7994-9284-bf70-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.PageBreak.PageBreakComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="9"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #beb7751d-9e88-4916-bd1e-050fd96dd2c3 .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="4448ab3e-34f2-4c6d-b217-73e12945f6cd">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#beb7751d-9e88-4916-bd1e-050fd96dd2c3" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn page-forward">Next</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="227c5226-e31d-6b2c-5b93-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Accommodation.AccommodationComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="10"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_23512f96-dcd7-444d-07c3-3a106a229111" class="text-left h3">
    <b>ACCOMMODATION</b>
  </div>
  <div class="row no-theme">
    <div class="col-xs-12">
      <p><span>Please confirm with Matt or Julie what day you will need to arrive in Dubrovnik, then update your check-in date using the drop-down box below. Any accommodation outside of these dates will be subject to</span> availability at the time
        of booking and payable directly to the hotel upon check-out.</p>
      <p>You are required to provide your credit card details as a guarantee for payment of any incidentals. This will be used to cover any incidental expenses incurred at the hotel, however you will have the opportunity to select an alternative
        method of payment upon check-out of the hotel. These may include (but are not limited to) room service, mini bar, laundry, room charges etc.</p>
      <p>To proceed please click the<strong> 'Search'</strong> button below:</p>
    </div>
  </div>
  <div id="check-in-out">
    <div class="row form-group has-feedback">
      <div class="col-sm-3">
        <label for="CheckIn_227c5226-e31d-6b2c-5b93-3a106a229111">Check-In Date</label>
      </div>
      <div class="col-xs-10 col-sm-6 col-md-4">
        <select aria-describedby="anchor_23512f96-dcd7-444d-07c3-3a106a229111" class="form-control select2-hidden-accessible" id="CheckIn_227c5226-e31d-6b2c-5b93-3a106a229111" name="CheckIn" tabindex="-1" aria-hidden="true" title="">
          <option value="2024-09-12">Thursday, September 12, 2024</option>
          <option value="2024-09-13">Friday, September 13, 2024</option>
          <option value="2024-09-14">Saturday, September 14, 2024</option>
          <option value="2024-09-15">Sunday, September 15, 2024</option>
        </select><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr" style="display: block;"><span class="selection"><span class="select2-selection select2-selection--single ignore-validation form-control"
              aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="CheckIn_227c5226-e31d-6b2c-5b93-3a106a229111_label" data-select2-focus="CheckIn_227c5226-e31d-6b2c-5b93-3a106a229111" role="combobox"><span
                class="select2-selection__rendered" id="select2-CheckIn_227c5226-e31d-6b2c-5b93-3a106a229111-container" role="textbox" aria-readonly="true" title="Thursday, September 12, 2024"><span class="select2-selection__clear">×</span>Thursday,
                September 12, 2024</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
      </div>
    </div>
    <div class="row form-group has-feedback">
      <div class="col-sm-3">
        <label for="CheckOut_227c5226-e31d-6b2c-5b93-3a106a229111">Check-Out Date</label>
      </div>
      <div class="col-xs-10 col-sm-6 col-md-4">
        <select aria-describedby="anchor_23512f96-dcd7-444d-07c3-3a106a229111" class="form-control select2-hidden-accessible" id="CheckOut_227c5226-e31d-6b2c-5b93-3a106a229111" name="CheckOut" tabindex="-1" aria-hidden="true" title="">
          <option value="2024-09-20">Friday, September 20, 2024</option>
        </select><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr" style="display: block;"><span class="selection"><span class="select2-selection select2-selection--single ignore-validation form-control"
              aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="CheckOut_227c5226-e31d-6b2c-5b93-3a106a229111_label" data-select2-focus="CheckOut_227c5226-e31d-6b2c-5b93-3a106a229111" role="combobox"><span
                class="select2-selection__rendered" id="select2-CheckOut_227c5226-e31d-6b2c-5b93-3a106a229111-container" role="textbox" aria-readonly="true" title="Friday, September 20, 2024"><span class="select2-selection__clear">×</span>Friday,
                September 20, 2024</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
      </div>
    </div>
  </div>
  <div class="row form-group">
    <div class="col-sm-3 col-sm-offset-3">
      <button id="updateResults" class="btn btn-default">Search</button>
    </div>
  </div>
  <div class="container-fluid">
    <div class="row hotel" data-hotel="{&quot;id&quot;:&quot;46a311b5-6f51-654f-ce71-3a0e906a5558&quot;,&quot;name&quot;:&quot;Sun Gardens Hotel&quot;,&quot;distance&quot;:0.00,&quot;starRating&quot;:0.00}" style="display: none;">
      <div class="col-sm-3 hidden-xs">
      </div>
      <div class="col-sm-9">
        <div class="panel panel-default">
          <div class="panel-heading">
            <h4 class="inline">Sun Gardens Hotel</h4>
            <span class="room-row-header pull-right nights"></span>
          </div>
          <ul class="list-group">
            <li class="list-group-item room-type-list">
              <div class="row room-type" id="048437e2-d635-23c6-00b9-3a0e906a55b5" data-roomtype="{&quot;id&quot;:&quot;048437e2-d635-23c6-00b9-3a0e906a55b5&quot;,&quot;name&quot;:&quot;King Room (1 Bed)&quot;}">
                <div class="col-sm-6 col-xs-12">
                  <label>King Room (1 Bed)</label>
                </div>
                <div class="col-sm-2 hidden-xs">
                </div>
                <div class="col-sm-4 col-xs-12 form-group">
                  <button name="add-room" id="add-room" class="btn btn-default pull-right inv-aware" data-inv-payment-status="Inclusive" data-inv-key="048437e2-d635-23c6-00b9-3a0e906a55b5" data-inv-type="Accommodation"
                    data-inv-waitlist-payment-status="" data-inv-waitlist-inventory-limit="" data-inv-waitlist-message="" data-inv-waitlist-label="" data-inv-enable-waitlist="false" data-inv-booknow-button-label="Book Room"
                    data-inv-allow-discount="false" data-inv-discount-required="false" data-inv-discount-code-key="048437e2-d635-23c6-00b9-3a0e906a55b5_DiscountCodeKey" data-inv-discount-code-value="" data-inv-discount-code-inv-type="DiscountCode"
                    data-inv-discount-code-container-id="048437e2-d635-23c6-00b9-3a0e906a55b5_Disco" aria-describedby="048437e2-d635-23c6-00b9-3a0e906a55b5">
                    <span class="glyphicon glyphicon-plus-sign"></span>&nbsp;Book Room </button>
                  <span class="label label-primary no-inventory pull-right" style="display: none;">FULL</span>
                  <button class="btn btn-default pull-right booked-inventory inv-aware" style="display: none;">BOOKED</button>
                </div>
              </div>
            </li>
          </ul>
        </div>
      </div>
    </div>
  </div>
  <script type="text/x-handlebars-template" data-templatename="roomBookingDetails">
    {{#each roomBookingDetails}}
      {{#if selected}}
        <div id="{{roomTypeId}}">
          <div data-booking="{{bookingId}}" class="well well-sm booking-details">
            <div id="booked_container_fluid" class="container-fluid">
              <div class="row">
                <div class="col-xs-6">
                  <h4>Booking Details</h4>
                </div>
                <div class="col-xs-6">
                  <button id="remove-cancel_{{bookingId}}" class="btn btn-default pull-right inv-aware" name="remove-cancel" data-inv-payment-status="None" data-inv-key="{{roomTypeId}}" data-inv-type="Accommodation"
                    aria-describedby="{{roomTypeId}}">{{#if booked}}Cancel{{else}}Remove{{/if}}</button>
                </div>
              </div>
              <div id="booked_room_detail_row" class="row booking-detail-row">
                <div class="col-sm-3"><label><strong>Booking Status</strong></label></div>
                <div id="booked_room_row_label" class="col-sm-9"><span class="label label-primary">BOOKED</span></div>
              </div>
              {{#if booked}}
              {{/if}}
              <div class="row booking-detail-row">
                <div class="col-sm-3"><label><strong>Hotel</strong></label></div>
                <div class="col-sm-9">{{hotelName}}</div>
              </div>
              <div class="row booking-detail-row">
                <div class="col-sm-3"><label><strong>Room Type</strong></label></div>
                <div class="col-sm-9">{{roomTypeName}}</div>
              </div>
              <div class="row booking-detail-row">
                <div class="col-sm-3"><label><strong>Check-In Date</strong></label></div>
                <div class="col-sm-9" data-ref-checkin="{{checkInDate}}">{{formatLongDate checkInDate}}</div>
              </div>
              <div class="row booking-detail-row">
                <div class="col-sm-3"><label><strong>Check-Out Date</strong></label></div>
                <div class="col-sm-9" data-ref-checkout="{{checkOutDate}}">{{formatLongDate checkOutDate}}</div>
              </div>
              {{#if booked}}
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Number Of Rooms</strong></label></div>
                  <div class="col-sm-9" id="numberOfRooms">{{numberOfRooms}}</div>
                </div>
              {{/if}}
              {{#unless booked}}
                <div class="row">
                  <label class='col-xs-8 col-sm-3' id='numberOfRooms_{{bookingId}}_label'>Number Of Rooms</label>
                  <div class='col-xs-6 col-sm-4 col-sm-offset-1 col-md-3'> <select id="numberOfRooms_{{bookingId}}" name="numberOfRooms_{{bookingId}}" class="form-control no-auto-save" data-type="number" data-no-clear="true"
                      data-selected="{{numberOfRooms}}" data-rebind="true" data-inv-payment-status="{{paymentStatus}}" data-inv-key="{{roomTypeId}}" data-inv-type="Accommodation"
                      data-reference-data="{ checkInDate: {{checkInDate}}, checkOutDate: {{checkOutDate}} }" data-input-type="number" data-inv-waitlist-inventory-limit="{{waitlistInventoryLimit}}"
                      data-inv-waitlist-payment-status="{{waitlistPaymentStatus}}" data-inv-original-payment-status="{{originalPaymentStatus}}" data-inv-enable-waitlist="{{enableWaitlist}}">
                      {{#repeat remaining}}
                        <option value="{{index}}">{{index}}</option>
                      {{/repeat}}
                    </select>
                    <div id="errorMessage_{{bookingId}}" class="hidden text-danger"></div>
                  </div>
                  {{#if canBeWaitisted}}
                    <div class="col-xs-5" style="width: 100%;">
                      <label class="normal-font">
                        {{{waitlistMessage}}} </label>
                    </div>
                    <div class="col-xs-5" style="width: 100%;">
                      <label class="normal-font">
                        <input checked="checked" disabled="disabled" id="WaitlistCheckbox" name="WaitlistCheckbox" type="checkbox"></input>
                        {{{waitlistLabel}}} </label>
                    </div>
                  {{/if}}
                </div>
                {{#if allowDiscount}}
                  <div id="{{discountCodeContainerId}}" class="row has-error has-feedback allow-discount discount-code">
                    {{#if discountRequired}}
                      <div class="col-sm-3">
                        <label for="discountCodeKey" class="field-required">Discount Code</label>
                      </div>
                      <div class="col-sm-9">
                        <input type="text" name="{{discountCodeKey}}" id="{{discountCodeKey}}" value="{{discountCodeValue}}" class="form-control inv-aware" data-inv-type="{{discountCodeInvType}}" data-inv-referenceid="{{roomTypeId}}"
                          data-inv-payment-status="{{paymentStatus}}" data-is-requesting-inventory="true" required {{#if discountCodeNoSubmit}} data-nosubmit {{/if}} />
                      </div>
                    {{else}}
                      <div class="col-sm-3">
                        <label for="discountCodeKey">Discount Code</label>
                      </div>
                      <div class="col-sm-9">
                        <input type="text" name="{{discountCodeKey}}" id="{{discountCodeKey}}" value="{{discountCodeValue}}" class="form-control inv-aware" data-inv-type="{{discountCodeInvType}}" data-inv-referenceid="{{roomTypeId}}"
                          data-inv-payment-status="{{paymentStatus}}" data-is-requesting-inventory="true" />
                      </div>
                    {{/if}}
                  </div>
                {{else}}
                  <input type="hidden" name="{{discountCodeKey}}" id="{{discountCodeKey}}" value="{{discountCodeValue}}" class="form-control inv-aware" data-inv-type="{{discountCodeInvType}}" data-inv-referenceid="{{roomTypeId}}"
                    data-inv-payment-status="{{paymentStatus}}" />
                {{/if}}
              {{/unless}}
              <div class="accom-logic">
                <div class="row form-group has-feedback">
                  <div class="col-sm-3">
                    <label for="specialRequirements_{{bookingId}}">Special Requirements</label>
                  </div>
                  <div class="col-sm-9">
                    <input type="text" class="form-control no-auto-save" id="specialRequirements_{{bookingId}}" data-logic-id="93e7f3c3-1c64-48ff-b9a6-5e7f2cd61083" name="specialRequirements" value="{{specialRequirements}}"
                      aria-description="{{roomTypeName}} {{hotelName}}" />
                    <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
                  </div>
                </div>
                <div> </div>
              </div>
            </div>
      {{else}}
        {{#if booked}}
          <div id="{{roomTypeId}}">
            <div data-booking="{{bookingId}}" class="well well-sm">
              <div class="container-fluid">
                <div class="row booking-detail-row">
                  <div class="col-xs-10">
                    <h4>Booking Details</h4>
                  </div>
                  <div class="col-xs-2">
                    <button id="uncancel_{{bookingId}}" class="btn btn-default pull-right" name="uncancel">Undo Cancel</button>
                  </div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Booking Status</strong></label></div>
                  <div class="col-sm-9"><span class="label label-primary">CANCELED</span></div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Hotel</strong></label></div>
                  <div class="col-sm-9">{{hotelName}}</div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Room Type</strong></label></div>
                  <div class="col-sm-9">{{roomTypeName}}</div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Check-In Date</strong></label></div>
                  <div class="col-sm-9" data-ref-checkin="{{checkInDate}}">{{formatLongDate checkInDate}}</div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Check-Out Date</strong></label></div>
                  <div class="col-sm-9" data-ref-checkout="{{checkOutDate}}">{{formatLongDate checkOutDate}}</div>
                </div>
                <div class="row booking-detail-row">
                  <div class="col-sm-3"><label><strong>Number Of Rooms</strong></label></div>
                  <div class="col-sm-9" id="numberOfRooms">{{numberOfRooms}}</div>
                </div>
                {{#if allowDiscount}}
                  <div class="row booking-detail-row">
                    <div class="col-sm-3"><label><strong>Discount</strong></label></div>
                    <div class="col-sm-9">{{currency}} {{discount}}</div>
                  </div>
                {{/if}}
              </div>
            </div>
          </div>
        {{/if}}
      {{/if}}
    {{/each}}
  </script>
  <input id="roomBookingDetailsSource_227c5226e31d6b2c5b933a106a229111" name="roomBookingDetailsSource_227c5226e31d6b2c5b933a106a229111" type="hidden" value="{}">
  <div data-templateplaceholder="roomBookingDetails" data-templatesource="roomBookingDetailsSource_227c5226e31d6b2c5b933a106a229111">
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="58979ffa-e675-cd4a-ad74-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Marketing.MarketingComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="11"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_46c991be-4856-b60e-fc11-3a106a229111" class="text-left h3">
    <b>ACCOMMODATION EXTENSION REQUEST</b>
  </div>
  <div class="text-left">
    <p> If you would like to extend your stay at Sun Gardens, the hotel group rate is from <b>270 EUR per night for a single room and 280 EUR per night for a twin / double room</b>. This rate is valid three days pre and post Red Forum event dates,
      subject to availability. <br><br>Please provide your request below and EWM will contact you directly to provide a quote within 5 business days. </p>
  </div>
  <div class="row form-group has-feedback bottom-padding-10">
    <div class="col-sm-3">
      <label for="8e97806c-25cf-4e39-8819-4d09d755a683"></label>
    </div>
    <div class="col-sm-9">
      <textarea class="form-control" cols="20" data-togglevisibility="" id="8e97806c-25cf-4e39-8819-4d09d755a683" name="8e97806c-25cf-4e39-8819-4d09d755a683" rows="2"></textarea>
      <span class="glyphicon glyphicon-warning-sign form-control-feedback has-error"></span>
    </div>
  </div>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="eb5eaaae-cc0e-06ac-a3b9-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.PageBreak.PageBreakComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="12"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #ffa11107-c34e-42b2-896b-c46fa51e48a6 .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="670ba203-775d-4cd1-9513-13e04ec33a8d">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#ffa11107-c34e-42b2-896b-c46fa51e48a6" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn page-forward">Next</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="d0518940-0d6e-4048-a98c-cd0b3fc6920c"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Marketing.MarketingComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="13"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" class="text-left h3">
    <b>FLIGHTS</b>
  </div>
  <div class="row no-theme">
    <div class="col-xs-12">
      <p>EWM can assist in booking flights on your behalf. If you prefer to book your own flights, please send a copy of your itinerary to <a href="mailto:wellared@ewm.com.au">wellared@ewm.com.au</a> so the team can assist you in booking arrival and
        departure transfers on main event dates.</p>
      <p><strong>Please select your required departure port if you wish for EWM to book your flights or 'I will book my own flights', if you wish to book your own.</strong></p>
    </div>
  </div>
  <input type="hidden" name="31a844fd-3733-4c92-a9a3-28b48e2b40dd" value="">
  <div class="row form-group has-feedback select">
    <div class="col-sm-3 text-left"><label for="{forId}" id="31a844fd-3733-4c92-a9a3-28b48e2b40dd_label" data-description-id="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" class="field-required">Please select</label></div>
    <div class="col-sm-9"><select hidden="" class="required select2-hidden-accessible" data-placeholder="Please select..." name="31a844fd-3733-4c92-a9a3-28b48e2b40dd" id="31a844fd-3733-4c92-a9a3-28b48e2b40dd" tabindex="-1" aria-hidden="true">
        <option></option>
        <option value="d44b9ae8-38ff-4a7f-87be-6d3243391122">Auckland</option>
        <option value="8700ac2e-36c6-4aa8-bc5f-ae4ab8e042c4">Brisbane</option>
        <option value="7cbd55fe-aabc-411b-a64a-8021b7cd00f0">Melbourne</option>
        <option value="d0a3a823-f7fc-4dd7-a7a9-7014e28cd03a">Perth</option>
        <option value="d0141de0-6b99-40e1-afd4-e0c65396b3e9">Sydney</option>
        <option value="076bbbfb-a940-4b9c-870f-adca2dea9139">I will book my own flights</option>
      </select><span class="select2 select2-container select2-container--bootstrap form-control" dir="ltr"><span class="selection"><span class="select2-selection select2-selection--single form-control" aria-haspopup="true" aria-expanded="false"
            tabindex="0" aria-labelledby="31a844fd-3733-4c92-a9a3-28b48e2b40dd_label" data-select2-focus="31a844fd-3733-4c92-a9a3-28b48e2b40dd" aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" role="combobox"><span
              class="select2-selection__rendered" id="select2-31a844fd-3733-4c92-a9a3-28b48e2b40dd-container" role="textbox" aria-readonly="true"><span class="select2-selection__placeholder">Please select...</span></span><span
              class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span></div>
  </div><input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown"
    data-label="Auckland" data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="d44b9ae8-38ff-4a7f-87be-6d3243391122" name="d44b9ae8-38ff-4a7f-87be-6d3243391122"
    type="hidden" value="">
  <input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown"
    data-label="Brisbane" data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="8700ac2e-36c6-4aa8-bc5f-ae4ab8e042c4" name="8700ac2e-36c6-4aa8-bc5f-ae4ab8e042c4"
    type="hidden" value="">
  <input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown"
    data-label="Melbourne" data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="7cbd55fe-aabc-411b-a64a-8021b7cd00f0" name="7cbd55fe-aabc-411b-a64a-8021b7cd00f0"
    type="hidden" value="">
  <input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown" data-label="Perth"
    data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="d0a3a823-f7fc-4dd7-a7a9-7014e28cd03a" name="d0a3a823-f7fc-4dd7-a7a9-7014e28cd03a" type="hidden" value="">
  <input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown" data-label="Sydney"
    data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="d0141de0-6b99-40e1-afd4-e0c65396b3e9" name="d0141de0-6b99-40e1-afd4-e0c65396b3e9" type="hidden" value="">
  <input aria-describedby="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" aria-required="required" data-groupinglabel="Please select" data-heading-description="anchor_ebc52eb4-caa6-4939-844a-063668fcc80c" data-input-type="dropdown"
    data-label="I will book my own flights" data-parent="31a844fd-3733-4c92-a9a3-28b48e2b40dd" data-placeholder="Please select..." data-required="required" data-selected="" id="076bbbfb-a940-4b9c-870f-adca2dea9139"
    name="076bbbfb-a940-4b9c-870f-adca2dea9139" type="hidden" value="">
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="504fc275-4e84-438d-a811-3aab97af69f6"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.PageBreak.PageBreakComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="0"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #bac14192-b04a-4105-b304-13069a178c2f .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="95ba4ece-9cb7-4d1b-94ae-533325e976d4">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#bac14192-b04a-4105-b304-13069a178c2f" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn page-forward">Next</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="63055824-53d7-d177-e810-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Summary.SummaryComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="14"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_5a184480-d599-6fcd-05fa-3a106a229111" class="text-left h3">
    <b>REGISTRATION SUMMARY</b>
  </div>
  <div class="text-left">
    <p> Please review the information you have entered below is correct before selecting <b>'Next'</b> to to proceed to payment. If you wish to make any changes select <b>'Edit'</b> to amend your registration. </p>
  </div>
  <input class="core-component-data" id="groupSummaryData" name="groupSummaryData" type="hidden" value="{}">
  <div data-templateplaceholder="groupSummary" data-templatesource="groupSummaryData" style="margin-bottom:10px;">
  </div>
  <script type="text/x-handlebars-template" data-templatename="groupSummary">
    {{#if isGroup}}
      <div class="container-fluid">
        <div class="row group-summary-header h4">
          <div class="col-sm-3 col-xs-3">Contact</div>
          <div class="col-sm-3 col-xs-3">Status</div>
          <div class="col-sm-3 col-xs-3 text-right">{{#if displayAmounts}}Total Amount{{/if}}</div>
          <div class="col-sm-3 col-xs-3"></div>
        </div>
        {{#each contacts}}
          <div class="row group-summary-row ">
            <div class="col-sm-3 col-xs-3" style="">{{FirstName}} {{LastName}}</div>
            <div class="col-sm-3 col-xs-3" style="">{{#if completed}}Completed{{else}}To Be Completed{{/if}}</div>
            {{#if ../displayAmounts}}
              <div class="col-sm-3 col-xs-3 text-right" style="">{{formatCurrency amount}}</div>
            {{else}}
              <div class="col-sm-3 col-xs-3"></div>
            {{/if}}
            {{#if completed}}
              <div class="col-sm-3 col-xs-3"><button data-togglevisibility="contact-summary-content-{{number}}" class="">Edit/View</button></div>
              <div class="col-sm-12 col-xs-12" id="contact-summary-content-{{number}}">
                <div class="well well-sm light-well summary-content " data-contact-number="{{number}}">
                  {{{summary}}}
                </div>
              </div>
            {{else}}
              <div class="col-sm-3 col-xs-3"><button data-switch-contact="{{number}}" class="">Register</button></div>
            {{/if}}
          </div>
        {{/each}}
        {{#if displayTotal}}
          <div class="row group-summary-row">
            <div class="col-sm-6 col-xs-6">
              <p class="text-right">Total Amount (Paid by {{#if groupContactPays}}group contact{{else}}Contact{{/if}})</p>
            </div>
            <div class="col-sm-3 col-xs-3 text-right">{{#if displayTotal}}{{sumCurrency contacts 'amount'}}{{/if}}</div>
          </div>
        {{else}}
          <div class="row group-summary-row" />
        {{/if}}
        <div class="row">
          <div class="col-sm-12 col-xs-12">
            <button data-edit-group="" class="">Edit Group</button>
          </div>
        </div>
      </div>
    {{else}}
      {{#each contacts}}
        <div class="summary-content " data-contact-number="{{number}}">
          {{{summary}}}
        </div>
      {{/each}}
    {{/if}}
  </script>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="e2fecc84-47fb-c13f-fdff-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.Submit.SubmitComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="15"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <style>
    #27e1aef5-861a-44c0-85a2-1ed4ea2a391d .modal-close {
      border: none;
      background: none;
      padding: 0;
      font-size: 18pt;
      margin: 0;
      line-height: normal;
      float: right;
      margin-top: -5px;
    }
  </style>
  <nav class="navbar navbar-inverse navbar-inside-page center-block" role="navigation">
    <div class="container-fluid">
      <div class="nav pull-left">
        <button type="button" class="btn btn-default navbar-btn page-cancelReturnUrl" style="display: none;">Cancel</button>
      </div>
      <div class="collapse navbar-collapse" id="b139266d-779d-4731-aee1-54c8c342ce1b">
        <ul class="nav navbar-nav">
        </ul>
      </div>
      <div class="alerts-watchers">
        <span class="fa fa-ok-sign text-success alerts-watcher" data-watchpriority="success" style="display: none;"></span>
        <span class="fa fa-info-sign text-info alerts-watcher" data-watchpriority="info" style="display: none;"></span>
        <span class="fa fa-exclamation text-warning alerts-watcher" data-watchpriority="warning" style="display: none;"></span>
        <span class="fa fa-remove-sign text-danger alerts-watcher" data-watchpriority="danger" style="display: none;"></span>
      </div>
      <div class="nav pull-right waiting-nav">
        <button type="button" class="btn btn-default navbar-btn page-summary" style="display: none;">Return to summary</button>
        <button type="button" class="btn btn-default navbar-btn page-backward">Back</button>
        <button type="button" class="btn btn-default navbar-btn page-cancel" style="display: none;">Cancel</button>
        <button type="button" class="btn btn-default navbar-btn page-cancelAll" data-toggle="modal" data-target="#27e1aef5-861a-44c0-85a2-1ed4ea2a391d" style="display: none;"> Cancel Registration</button>
        <button type="button" class="btn btn-default navbar-btn form-submit">Submit</button>
        <button type="button" class="btn btn-default navbar-btn group-forward" style="display: none;">Next</button>
      </div>
      <span class="navbar-right" style="display: none" data-navigation-watcher=""></span>
    </div>
  </nav>
</form>

<form class="dynamic-target form-horizontal clearfix    ">
  <input class="core-component-data" name="ComponentConfigurationId" type="hidden" value="8cd79feb-9c3e-46a9-67a2-3a106a229111"><input class="core-component-data" name="ConcreteType" type="hidden"
    value="NextGen.Online.Components.Client.ThankYou.ThankYouComponent"><input class="core-component-data" name="ComponentNumber" type="hidden" value="16"><input class="core-component-data" name="IsEditable" type="hidden" value="true">
  <div id="anchor_75c1f19e-7706-8851-ee70-3a106a229111" class="text-left h3"> Thank You </div>
  <div class="row no-theme">
    <div class="col-xs-12">
      <p>Your registration has been received for the Wella Red Forum 2024, held in Dubrovnik from Sunday, 15 - Friday, 20 Septmeber 2024.</p>
      <p>If you have any questions please do not hesitate to contact The Wella Red Event Team on&nbsp;<a href="mailto:wellared@ewm.com.au" target="_blank" rel="noopener">wellared@ewm.com.au</a><br><br><br></p>
    </div>
  </div>
</form>

Text Content

STAFF REGISTRATION

Welcome to the staff registration form for the Wella RED Forum 2024 to be held
in Dubrovnik, Croatia from Sunday 15 - Friday 20 September 2024.

Please see below information about the upcoming Forum and important information
in order to complete your registration. Should you have any queries whilst
completing the form, please contact the Wella Red Event Team directly on
wellared@ewm.com.au.


ACCOMMODATION

Prior to commencing the registration, please confirm with Matt or Julie what day
you will need to arrive in Dubrovnik, as you will need to select your check in
date to secure your accommodation and proceed through the registration process.


MAIN EVENT DATES

Sunday 15 - Friday 20 September 2024


VENUE

Sun Gardens Hotel, Dubrovnik


CONTACT

Wella Red Event Team
Email: wellared@ewm.com.au
Phone: +61 459 349 932

 

Please select 'Wella Staff' to complete your registration.

Wella Staff FULL
Cancel


Return to summary Back Cancel Cancel Registration Next Next

CONTACT DETAILS

Please complete all details below as per your photo identification or passport
to ensure all future travel bookings are made correctly.

If you need to change any of the below information, please contact the Wella Red
Event Team on wellared@ewm.com.au.

Title
Mr Miss Mrs Ms Mx
First name

Middle Name

Last name

Organization

Job title

Email address

Mobile

Cancel


Return to summary Back Cancel Cancel Registration Next Next

HOME ADDRESS
Street Address

Suburb

State

Postcode

Country

NAME BADGE

Please advise your preferred name for reference during the event.

Preferred First Name

Preferred Last Name

EMERGENCY CONTACT DETAILS

In the case of an emergency please advise who we should contact. Please provide
a contact of someone not travelling with you.

Full Name

Phone Number

Relationship

DIETARY AND MEDICAL REQUIREMENTS

Your dietary and medical requirements are kept confidential, and only provided
to third parties whom are required to be informed in order to support you in
your request.

Please select your dietary requirement from the drop down list below; if you do
not have a dietary requirement, please leave blank.

Dietary Requirements
Coeliac Dairy free Diabetic Egg free Gluten free/coeliac Halal Kosher
Lacto-Vegetarian No beef No pork No seafood Nut allergy Other (please specify)
Ovo-Vegetarian Pescatarian Pescetarian Seafood allergy Seafood and nut allergy
Shellfish allergy Soy allergy Vegan Vegetarian Wheat free Other
 * 

Other

Medical Condition


Please advise if you require any mobility or accessibility assistance.

Mobility / Accessibility Assistance

PASSPORT DETAILS

It is a requirement by the Croatian Government that the following details are
recorded by the hotel. If you do not have a passport or it will be expired by
the time of travel, please leave this blank and EWM will follow up with you at a
later time.

Passport Number

Passport Expiry Date
July 2015

Su Mo Tu We Th Fr Sa Javascript must be enabled

Close
Click or press the Enter key or the spacebar to open the calendar
Go to previous month
Go to next month
Go to previous year
Go to next year
Close the date picker
Passport Country

Date of Birth
July 2015

Su Mo Tu We Th Fr Sa Javascript must be enabled

Close
Click or press the Enter key or the spacebar to open the calendar
Go to previous month
Go to next month
Go to previous year
Go to next year
Close the date picker
Country of Citizenship

Country of Birth

City of Birth

Cancel


Return to summary Back Cancel Cancel Registration Next Next

ACCOMMODATION

Please confirm with Matt or Julie what day you will need to arrive in Dubrovnik,
then update your check-in date using the drop-down box below. Any accommodation
outside of these dates will be subject to availability at the time of booking
and payable directly to the hotel upon check-out.

You are required to provide your credit card details as a guarantee for payment
of any incidentals. This will be used to cover any incidental expenses incurred
at the hotel, however you will have the opportunity to select an alternative
method of payment upon check-out of the hotel. These may include (but are not
limited to) room service, mini bar, laundry, room charges etc.

To proceed please click the 'Search' button below:

Check-In Date
Thursday, September 12, 2024Friday, September 13, 2024Saturday, September 14,
2024Sunday, September 15, 2024×Thursday, September 12, 2024
Check-Out Date
Friday, September 20, 2024×Friday, September 20, 2024
Search

SUN GARDENS HOTEL

 * King Room (1 Bed)
   
    Book Room FULL BOOKED


ACCOMMODATION EXTENSION REQUEST

If you would like to extend your stay at Sun Gardens, the hotel group rate is
from 270 EUR per night for a single room and 280 EUR per night for a twin /
double room. This rate is valid three days pre and post Red Forum event dates,
subject to availability.

Please provide your request below and EWM will contact you directly to provide a
quote within 5 business days.


Cancel


Return to summary Back Cancel Cancel Registration Next Next

FLIGHTS

EWM can assist in booking flights on your behalf. If you prefer to book your own
flights, please send a copy of your itinerary to wellared@ewm.com.au so the team
can assist you in booking arrival and departure transfers on main event dates.

Please select your required departure port if you wish for EWM to book your
flights or 'I will book my own flights', if you wish to book your own.

Please select
AucklandBrisbaneMelbournePerthSydneyI will book my own flightsPlease select...
Cancel


Return to summary Back Cancel Cancel Registration Next Next

REGISTRATION SUMMARY

Please review the information you have entered below is correct before selecting
'Next' to to proceed to payment. If you wish to make any changes select 'Edit'
to amend your registration.


Cancel


Return to summary Back Cancel Cancel Registration Submit Next

Thank You

Your registration has been received for the Wella Red Forum 2024, held in
Dubrovnik from Sunday, 15 - Friday, 20 Septmeber 2024.

If you have any questions please do not hesitate to contact The Wella Red Event
Team on wellared@ewm.com.au






YOU NEED TO ENABLE JAVASCRIPT TO ACCESS THIS SITE.

Follow these instructions on how to enable JavaScript.


INTERNET EXPLORER

 1. Select Tools from the top menu
 2. Choose Internet Options
 3. Click on the Security tab
 4. Click on Custom Level
 5. Scroll down until you see the section labelled Scripting
 6. Under Active Scripting, select Enable and click OK


GOOGLE CHROME

 1. Select the menu icon on the browser toolbar
 2. Select Settings
 3. Click the Show advanced settings... link then Content Settings in the
    Privacy section
 4. Select Allow all sites to run JavaScript (recommended) and click Done


SAFARI (MAC)

 1. Select Safari from the top menu
 2. Choose Preferences
 3. Choose Security
 4. Select the checkbox next to Enable JavaScript

Formats






 
Words: 0


Close

×

We are using a temporary cookie to streamline your experience. No personal data
is stored and the cookie is removed once you complete your registration.

YOUR BROWSER SETTINGS HAVE COOKIES DISABLED

This site requires a temporary cookie to streamline your experience. No personal
data is stored and the cookie will be removed once you complete your
registration. Please enable cookies in your browser and refresh this page.

×