Create a Form using CSS, HTML, Bootstrap, PHP and jscript

The form is to be as light, clean and crisp as possible. 1. Create a form using these fields [login to view URL] 2. Must be PHP and javascript based. 3. Layout must be CSS and Boostrap 4. No Images, just a solid color background. 5. Form must be emailed to a single or multiple emails addresses. 6. Confirmation Message must appear when form is submitted. Preferably disappear the form and provide a confirmation message as opposed to sending user to a different page. 7. Proper Validation of fields that are marked as required with an "*". 8. Proper Error messages if field not filled in correctly. 9. Dates can be input manually or through dropdown Calendar. 10. This is the info for the dropdowns: North American Cruise Port: Any Florida Port Baltimore Barbados Boston Charleston Fort Lauderdale Galveston Honolulu Jacksonville Long Beach (Los Angeles) Miami Mobile New Orleans New York Norfolk Other (Non-North American) Port Canaveral (Orlando) Quebec City San Francisco San Juan Seattle Seward Tampa Vancouver Cruise Line: Best Savings Carnival Cruise Line Celebrity Cruise Line Norwegian Cruise Line Royal Caribbean Cruise Line Cruise Destination: Alaska Bahamas Bermuda Best Savings Canada Caribbean Cuba Hawaii Mexican Riviera Pacific Coastal Panama Canal Transatlantic