Event Entry/Sign up Form re-designed

I have a pre-existing entry/sign up form for an event that I need re designed.
It is currently in a landscape layout and is very outdated.
I would like the form re-created with all of the information I provide. I would like to have it as a microsoft word file or a PDF - I can also work with an excel file although prefer not to due to the variety of people who will need to edit the form in the future.
The form is a 1 page form and has simple content.

I will provide a copy of the current form (an old sample is attached) and have a partial layout of what I would like created.

This project is time sensitive, needing to be completed by Feb 28, 2023.