Contest Website Submit Form

I am currently working on a website called [login to view URL], i have already build the form in the website and i need support to build me the form including it's validation, and form submit to my email address. So have a look at my website as i have listed my requirements below: You can see two groups in this website which has some check box, i want you to build a validation like if a user clicks on four check box then he should get a prompt stating that he can only select four teams again same function should be done to Group B. Now, after doing check mark and feeding details user should have email and contact number validation and i want to include a ref id field which you will not find in the demo but it's an extra field that i need you to do it for me. After this i need user data to be submitted to my email ID and after sending mail user should get a prompt stating THANK YOU and redirected to the Main Page within 10 seconds... So would you be able to do this if yes then please let me know. If you need to build your own form and then you can send me to upload then also it's good but make sure it should not affect my design and should have some space for country flags just like it's mentioned in the URL: [login to view URL]