Reuse Perch Region For Options In Contact Form

I have a perch area which allows the client to add multiple open day dates to a page, and want to be able to take this data and add it to a contact form to allow people to select the correct date.

Code is:

 <section class="main nine">
            <?php perch_content('Open Day Info')?>
            <h3>The London Programme</h3>
            <?php perch_content('London Info')?>
            <?php perch_content('London Dates')?>

            <a href="#" title="Click To Apply" class="btn">Register For Open Day</a>

            <form id="form" method="post" action="open-days.php">
                <fieldset>
                    <label for="name">Name:</label>
                    <input type="text" id="name" name="name" placeholder="Please Enter Your Name">
                </fieldset>
                <fieldset>
                    <label for="email">Email:</label>
                    <input type="email" id="email" name="email" placeholder="Please Enter Your Email Address">
                </fieldset>
                <fieldset>
                    <label for="address">Address:</label>
                    <textarea id="address" name="address" placeholder="Please Enter Your Full Address"></textarea>
                </fieldset>
                <fieldset>
                    <label for="date">Open Day Date</label>
                    <select>
                        <option><?php perch_content('London Dates')?></option>
                    </select>
                </fieldset>
                <fieldset>
                    <input type="submit" value="Submit" name="submit">
                </fieldset>
            </form>

You can view the development site here

Any ideas as at the moment it is working but all the dates are showing up in one <option> field and i want it to be multiple option fields

The perch region code is

<p><perch:content id="open-day-dates" type="text" label="Open Day Date" required="true" title="true" /></p>