Send email to a custom field

Hi,

I would like to know if it is possible to send an email to a custom field.

Example: If you are in a store in particular as this: http://www.bemyguest.folkamedia.com/tienda/mili-maciel-make-up/ when you press the button “Solicitar Presupuesto” opens a contact form in a lightbox.
This form should be sent to that particular store.

Is that possible?

Thanks!