@ @ Jason
Sorry, no, I did not look. I apologize as I missed your reply. I activated NextGen Gallery on my test site and Form still functions fine. So may there is a specific setting or perhaps an extension plugin that your using for NextGen Gallery which is the actual source of the problem.
You gave the user/pass … but not the login URL for the site in question so I don’t really know where to login and check.
If you posts private reply, please post a follow-up non-private reply so I get notified of your reply, thanks!