Using Text Answer to Track Completion

Thanks to this community for your ideas, solutions, and suggestions!

The course I am building needs to track user completion only through an acknowledgement statement (the statement says, basically, that the user is completing the course independently and without assistance from anyone else). We would like to capture the user acknowledgement through a simple text entry: type your name here, enter the date, submit the form.

I have the acknowledgement set as a test section and have tried several ways to record completion but am constantly getting errors. One way I have tried is to use a question element for name entry, with an entry field for the user to type his/her name, followed by another question element for the date entry. Neither passes - when I try to type anything in either field (including pressing the shift key!), the error appears, "You must choose an answer to continue."

Another way was to create a text box with an action linked to a simple checkbox (enter your name, then click the box to allow you to submit the form). That didn't even get off the launchpad, either.

Any ideas would be appreciated. We are really looking for the easiest way to make the user acknowledge that he or she has read the conditions listed on the page (read text) and then submit his/her name as a way to track that (enter name, submit page/form).