These are two versions a simple HTML form. One is using Javascript, the other one jQuery library.

It is supposed to contain fields for:

Date (has to be be no older than one year and no newer than one year)

Last Name (can contain only letters, polish letters, spacebar and -)

IP (Has to fit typical IP pattern and cannot be 127.0.0.1)

Text (Cannot be longer than 230 characters)

All fields have to be checked and cannot be empty to click Submit button.