Can I make a form to create a new user on my website?

I am trying to create a form that will ask user for all relevant information to create a User account on my website. It will ask for name, address, email, phone, Username and Password. I know the username and password fields, especially with single text entries, are flags for phishing attempts, but is there any to get exemption for this error with proof of legitimacy? 

Wanting to use JotForm to create cross-platform compatible forms for use on a developing server.

Unfortunately, it's not possible to ask such information at all through JotForm forms, I'm afraid that it's not possible to allow any users to collect such info since as explained on our terms page, this violates our terms. 

Thanks.