Wordpress Contact Form With Attachements

This project is to implement a simple contact form that allows users to also attach pictures to there submitted content in an existing Wordpress install on the site. The contact form will be used for a contest and will have specific variables: Name Age Phone Cell Address Email Comments (maybe one or two more variables as well) Additionally, they will also have to check off that they have read the terms and conditions via a checkbox before submitting. Lastly, they will need the ability to upload a picture as well in order to submit. Ideally, the information is emailed to a contact and is also stored in there database in order to access it at any time. The project needs to be done as quickly as possible. Please include details of your skill as well as the quickest turnaround time for this project. We would like to stay around the $125.00 budget for this project.