I need an A4 one sided editable PDF entry form made up

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Jane P.Mohammed A.Ali H.Chris & Izania A.Muhammad Riaz S. have already sent a proposal.
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Description

Experience Level: Entry
Estimated Job duration: need back in next 2 hours!!!
II need an A4 one sided editable PDF entry form made up.

I have the banner I need already designed (this will be placed at the top of the page)

Then the intro:

The IBFA would like to take this opportunity to thank you for entering the IBFA County Durham Show, that will take place on Sunday 10th May 2015 at The Dolphin Centre, Darlington.

Registration for the show will commence at 11.30am and the show will start at 1.00pm.

Please fill in the form below and let us know what categories you would like to compete in, then email the form back to browngrant30@yahoo.co.uk


Then what I require are the following fields, so they can type a reply in:
Name:
Date of Birth:
Hometown/City:
Gym Representing:

Then I need a list of categories where the reader can click an option or at least be able to type YES next to it, preferably in box. These can be in 2 or 3 columns.

Junior Under 18yrs (1997 and after)
Junior Under 23yrs (1992 and after)
First Timers
Novice
Over 45 yrs
Over 55 yrs
Athletic Short
Athletic Tall
Toned Figure
Trained Figure
Mr Short (under 170cm)
Mr Medium (170cm-178cm)
Mr Tall (over 178cm)
Mr Darlington

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