Create a form for adding/editing opening hours

I'm looking for someone who is able to do the programming of a form sheet with html+javascript mostly like the added screenshot. When clicking the submit button the data should be available in a way which may be stored in database and be displayed on a website. What I need: - All opening days and the possibility to add the opening hours (1 or 2 time slots) - Possibility for closed days - Possibilty to add text for the option "by arrangement" - Chance to store/restore/parse the data The form is german and if you need any advice for the days/opening hours I can provide you with some help.