SIMPLE Custom Coding for unique Registration Form

PLEASE READ CAREFULLY: I am willing to work with new Freelancers if you can perform all of the work/functions stated. If you cannot, DO NOT BID because you will not be paid and will receive a negative review. OVERVIEW: I need a unique registration form created that will do a few things for my website EXACTLY AS DESCRIBED. The website is for a fitness challenge and the registration form will be to sign up for this free challenge. However, the user must provide an "Entry Code" to be allowed to register. There will be several codes (40-60 codes) which will be assigned to different teams. An individual can only register if they receive and enter a valid entry code from one of the team members. WHAT THE FORM WILL CONTAIN: First Name: _______________ Last Name: ______________ Address: ___________ City: __________ State: (drop down box) Zip Code: __________ Email: _____________ Phone Number: ___________ Program Selected (bullet points so they can onlu choose one): o Weight Loss o Muscle Gain o Weight Maintenance o Undetermined Entry Code: ______ FUNCTIONS OF THE FORM: 1) If the user does not fill out all fields, they will be asked to fill the missing fields. All fields are required. 2) If the user enters an incorrect entry code, it will state to "Entry Code Invalid. Please contact the individual who referred you for the correct Entry Code." 3) If user registers successfully with a valid entry code, they will be forwarded to the Congratulations page determined by which Program they selected (4 different page options). 4) A generic email will be sent to the user when they register successfully welcoming them and providing some additional details, including a reminder of the entry code for later use. 5) Team Leaders will be assigned Entry Codes that they can distribute to others. When someone registers using their Entry Code, only that specific Team Leader will get an email stating somebody has registered and their contact information. There will be approximately 40-60 different codes and separate emails assigned to each (I will set the codes and emails for you). 6) I would also like a database of all registrant details saved somewhere on the site so the administrators can access it if need be. PLEASE ONLY BID IF YOU CAN DO THIS QUICKLY AND ENTIRELY. IF YOU DO NOT UNDERSTAND SOMETHING, ASK!!!! GOOD LUCK!!!!