The Coco Café Friends
It was a pleasure serving you at The Coco Café!
As a token of appreciation, please fill out your information below to receive an exclusive discount on a stay at Boardwalk Boutique hotel.
We look forward to welcoming you back!
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<legend> Receive your exclusive discount.</legend>
<div>
<label>First/ Last Name</label>
<input type="text" name="firstName"/><input type="text" name="lastName"/> </div>
<div>
<label>Gender</label>
<input class="long" type="text" name="gender"/> </div>
<div>
<label>Country</label>
<input class="long" type="text" name="country"/> </div>
<div>
<label>Phone Number</label>
<input class="long" type="tel" name="phone"/> </div>
<div>
<label>Email</label>
<input class="long" type="email" name="email" required/> </div>
<div>
<label>Date Of Birth</label>
<select name="yearOfdateOfBirth" data-group="dateOfBirth" data-delimiter="-"><option value="">Year</option><option value="2024">2024</option><option value="2023">2023</option><option value="2022">2022</option><option value="2021">2021</option><option value="2020">2020</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option></select><select name="monthOfdateOfBirth" data-group="dateOfBirth" data-delimiter="-"><option value="">Month</option><option value="01">01</option><option value="02">02</option><option value="03">03</option><option value="04">04</option><option value="05">05</option><option value="06">06</option><option value="07">07</option><option value="08">08</option><option value="09">09</option><option value="10">10</option><option value="11">11</option><option value="12">12</option></select><select name="dayOfdateOfBirth" data-group="dateOfBirth"><option value="">Day</option><option value="01">01</option><option value="02">02</option><option value="03">03</option><option value="04">04</option><option value="05">05</option><option value="06">06</option><option value="07">07</option><option value="08">08</option><option value="09">09</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select> </div>
<div class="button">
<button type="submit">Sign Me Up !</button>
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By submitting your information, you are opting in for marketing promotional content from Boardwalk Boutique Hotel and The Coco Café