Emergency: Web Payment Form

Hello. I am up against a tight deadline to get a registration and payment form completed. I had posted a project on Getafreelancer on 12/17/08. It is here: [login to view URL] I informed the coder that I needed one of the forms working by the new year, and she said it wouldn't be a problem. Well, she has disappeared; I have not been able to contact her for several days, and the client is supposed to start accepting registrations for an event this next week! In short, I need some immediate help to get this one form completed. There are two main files involved in the forms. There is the form itself which gathers the info, then the next page shows the data and asks the user to verify. Both are PHP pages, and there is some Javascript used as well for a couple of the fields. Everything is created, but we have several changes that need to be made. The details of each registration are also to be emailed to the registrant and the client. Again, that is already set up, but there may be a couple changes based on any new fields that were added. I have not pulled the entire project from the other provider yet. I am a fair person and want to give her the opportunity to explain. But I need to get this one form done this weekend so that it is ready to go next week. So if you can come through for me, you will be my hero! It would be very beneficial if you are a good communicator in English so there is no miscommunication. Please let me know if you have any questions before bidding. I plan to award this project in the next several hours.