Problem with Select boxes

https://kidsandcancerbenefitrun.com/test-4/

The select boxes are at the bottom of the page. This is a test page that demonstrates the problem. I had to make the live page work by using text boxes instead.

Here is the requested screenshot: https://snipboard.io/DhpEam.jpg

I changed the email address to use a fake email just for making the screenshot. Also, this form has a disabled redirection. I use the redirect on the real page and tested it originally with this form, but I disabled that redirect on this form to see if that made a difference and it still would not send.

The theme is HitMag Pro and here is the list of plugins:

https://snipboard.io/paSwCe.jpg