DEA Registration Form !

Hi, I need someone to create a form for capturing data from people. There will be a combination of checkboxes and text boxes. There is 41 questions in total. Certain fields will be required fields and the user will not be able to submit until certain fields have been completed. The user will also be required to tick a checkbox to say that they have read and understood the terms and conditions. An email confirmtaion will need to be sent. The data then goes into my database so you will need to create the extra tables required. I will need an option in my admin panel to accept the registration by the user and approve their application. A new email is then sent to confirm that I have accepted the application. This is required urgently. Thanks Chris