Add detail list to Form

Hello

Is it possible to drop a list that I have created in my list and detail into a form on the forms app.

Have a list of cities which I want as a checkbox list on my contact form .

This is my list

<?php

     perch_content_custom('Destinations', array(
      'template' => 'dest-list.html',
      'page'=>'/destinations.php',
      'category' => perch_get('cat'),

    ));


    ?>

but I would only need to get part of template <perch:content id="destcity" type="text" />

The part of form it would go in is...

<perch:input id="city1" name="city1" class="element checkbox" type="checkbox" value="1" />
<perch:label class="choice" for="city1">First city</perch:label>

  <perch:input id="city2" name="city2" class="element checkbox" type="checkbox" value="1" />
  <perch:label class="choice" for="city">Second city</label>

  <input id="city3" name="city3" class="element checkbox" type="checkbox" value="1" />
  <perch:label class="choice" for="city3">Third city</label>

...and so on

Obviously it would be a lot easier and better for future updates if I could just pass list through here rather than delisting individually.

thanks

Denise