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April 26th, 2003, 03:26 AM

Lanndshark

Junior Member

Join Date: Mar 2003

Location: Phoenix, AZ USA

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Help with PHP

Help!!!

I'm re-doing a web site for my son's swimming teacher. She previously had a registration form called contact.php.

I've never done anything with php and cannot seem to hack, thrust and cut my way through this. I've got the old form and what I've tried to redo - which keeps returning an error message to me - not good!

Can someone that is conversant with PHP take a quick look at it and maybe point me in the right direction?

Thanks!
Larry

April 26th, 2003, 09:08 PM

rustybrick

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Join Date: Apr 2003

Location: New York, USA

Posts: 2,642

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send it to me at .com (pm me when you send it - so i know to check that address)

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April 26th, 2003, 09:22 PM

dhecker

Contributing User

Join Date: Mar 2003

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I'd be happy to look at it, too. You can post the code right to this thread and I'm sure we could help you out..

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April 26th, 2003, 11:32 PM

Lanndshark

Junior Member

Join Date: Mar 2003

Location: Phoenix, AZ USA

Posts: 10

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my attempt to revise the php

<?
// contactus.php
// Geoffrey Bush
// a.k.a. The Firelord (Taking Programs One Step Further)

if ($Visited == "")
{
$Visited = "Yes";

$form_block="<HTML><HEAD><TITLE>Water survival training for babies, toddlers and children :: Kids Aquatic Center ::</TITLE>" .
"<STYLE TYPE="text/css">a:link { color: blue; text-decoration: underline }" .
"a:active { color: red; text-decoration: none }a:visited { color: blue; text-decoration: none }" .
"a:hover { color: red; text-decoration: underline; background: #F9EDED }" .
"</STYLE> </HEAD><BODY bgcolor="#F2F6FD" topmargin="0" leftmargin="0" marginheight="0" marginwidth="0" TEXT="Black">" .
"<script type='text/javascript' src='http://www.kidsaquaticcenter.com/noclickbubbles.js'></script>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/Kacilogo1.gif" HEIGHT="92" WIDTH="132">" .
"<IMG SRC="http://www.kidsaquaticcenter.com/KACI_logo2.gif" HEIGHT="85" WIDTH="500">" .
"<H2><CENTER><B><FONT FACE="Arial" SIZE="5">K.A.C.I. - Teaching Infant, Toddler and Kids <BR>" .
"Advanced Water Survival since 1979</FONT></H2></CENTER></H2>" .
"<TABLE width="95%" border="0" cellpadding="15" cellspacing="0"><TR ><TD width="10%">" .
"<script type='text/javascript' >//HV Menu v5.411- by Ger Versluis (http://www.burmees.nl/)" .
"//Submitted to Dynamic Drive (http://www.dynamicdrive.com)//Visit http://www.dynamicdrive.com for this script and more" .
"function Go(){return}</script><script src='http://www.kidsaquaticcenter.com/kacimenu_var.js'></script>" .
"<script type='text/javascript' src='http://www.kidsaquaticcenter.com/menu_com.js'></script>" .
"<noscript>Your browser does not support script</noscript>" .
"<CENTER><FONT FACE="Arial"><IMG SRC="http://www.kidsaquaticcenter.com/nullpix.gif" HEIGHT="450" WIDTH="2">" .
"Member<IMG SRC="http://www.kidsaquaticcenter.com/NSSA.jpg" HEIGHT="73" WIDTH="92">" .
"<IMG SRC="http://www.kidsaquaticcenter.com/nullpix.gif" HEIGHT="100" WIDTH="2">" .
"</CENTER><FONT SIZE="-2"><a href="http://www.kidsaquaticcenter.com/">Home</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/philosophy.htm">About KACI</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/newsletter.htm">Newsletter</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/preregistration.htm">Pre-registration Form</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/picturegallery.htm">Picture Gallery</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/sitemap.htm">Site Map</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/guestbook.htm">Guestbook</a><BR>" .
"</FONT></FONT></TD><TD><CENTER>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/Kinleysittingonside.jpg" HEIGHT="211" WIDTH="122">" .
"               " .
"<IMG SRC="http://www.kidsaquaticcenter.com/zach_dive_b.jpg" HEIGHT="211" WIDTH="126">" .
"</CENTER><P><FONT FACE="Arial" SIZE="3"><FONT COLOR="#5008B8" SIZE="+1"><B>" .
"PRE-REGISTRATION INFORMATION:</B></FONT><P>Please keep in mind that after" .
"submitting this pre-registration form, a timeslot is not confirmed until" .
"you are contacted with the day and time. All forms submitted will be" .
"processed and students are <U><B>then put on a waiting list</B></U>" .
"in the order that the forms are received.<BR><P>" .
"<FORM NAME=REG ACTION=\"contactus.php\" METHOD=POST>" .
"<TABLE ALIGN=CENTER BORDER=4 CELLSPACING=2><CAPTION ALIGN=TOP>" .
"<BIG><BIG>Student Information</BIG></BIG></CAPTION><HR SIZE="2" WIDTH="100%" ALIGN="CENTER">" .
"<TR><TD WIDTH=110>First Name:</TD><TD><INPUT NAME=ChildFrstName SIZE=20 MAXLENGTH=20>" .
"Last Name: <INPUT NAME=ChildLstName SIZE=20 MAXLENGTH=20></TD></TR><TR>" .
"<TD WIDTH=110>Birth Date: </TD><TD><INPUT NAME=BDate SIZE=10 MAXLENGTH=10>" .
"<SMALL><SMALL><B>(Example:01/01/2002)</B></SMALL></SMALL>Phone:" .
"<INPUT NAME=HomePhone SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Address 1:</TD>" .
"<TD><INPUT NAME=Address1 SIZE=55 MAXLENGTH=55></TD></TR><TR><TD WIDTH=110>Address 2:</TD>" .
"<TD><INPUT NAME=Address2 SIZE=55 MAXLENGTH=55></TD></TR><TR><TD WIDTH=110>City:</TD>" .
"<TD><INPUT NAME=City SIZE=10 MAXLENGTH=10>State: <INPUT NAME=State SIZE=2 MAXLENGTH=2>" .
"Zip: <INPUT NAME=Zip SIZE=5 MAXLENGTH=5></TD></TR></TABLE>" .
"<TABLE ALIGN=CENTER BORDER=4 CELLSPACING=2 CELLPADDING="2"><BR><CAPTION VALIGN=MIDDLE>" .
"<BR><BIG><BIG> Parent Information</BIG></BIG></CAPTION><BR>" .
"<HR SIZE="2" WIDTH="100%" ALIGN="CENTER"><TR><TD WIDTH=110>Mom's Name:</TD>" .
"<TD>First:<INPUT NAME=Mom1stName SIZE=20 MAXLENGTH=20><BR>Last:" .
"<INPUT NAME=MomsLastName SIZE=20 MAXLENGTH=20></TD></TR><TR><TD WIDTH=110>Employer: </TD>" .
"<TD><INPUT NAME=MomsEmployer SIZE=25 MAXLENGTH=25>Phone:" .
"<INPUT NAME=MomWkPhn SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Dad's Name:</TD>" .
"<TD>First:<INPUT NAME=Dad1stName SIZE=20 MAXLENGTH=20><BR>Last:" .
"<INPUT NAME=DadsLastName SIZE=20 MAXLENGTH=20></TD></TR><TR><TD WIDTH=110>Employer: </TD>" .
"<TD><INPUT NAME=DadsEmployer SIZE=25 MAXLENGTH=25>Phone:" .
"<INPUT NAME=DadWkPhn SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Emergency Contact:<BR>" .
"<SMALL><B>*Other than<BR> parent(s)</B></SMALL></TD><TD>Name:" .
"<INPUT NAME=EmerContact SIZE=25 MAXLENGTH=25><BR>Phone:" .
"<INPUT NAME=EmerCntctPhn SIZE=12 MAXLENGTH=12><BR>Relation:" .
"<INPUT NAME=Relation SIZE=25 MAXLENGTH=25></TD></TR><TR><TD WIDTH=110>Special needs:</TD>" .
"<TD><textarea name="SpNeeds" cols="50" rows="2" wrap="soft"></textarea>" .
"<SMALL><B>* Medical info, physical limitations, etc.</B></SMALL></TD></TR><TR>" .
"<TD>Family Physician: </TD><TD><INPUT NAME=Doctor SIZE=30 MAXLENGTH=30>" .
"Phone: <INPUT NAME=DocPhone SIZE=12 MAXLENGTH=12</TD></TR></TABLE><BR>" .
"<FONT STYLE="font-family:Book Antiqua, Comic Sans MS, Tempus Sans ITC">" .
"<TABLE border="1" bgcolor="#101488"><TR><TD ROWSPAN=2 BGCOLOR=#B8CCF8>" .
"<CENTER><BR><B><U>AFFIRMATION/LIABILITY RELEASE AND EXPRESS ASSUMPTION" .
"OF RISK</U></B></CENTER><BR><B>Waiver & Release:</B> <BR><blockquote>" .
"I/We, as parent(s)/guardian(s), authorize the participation of the above named" .
"student in any and all Kids' Aquatic Center, Inc. actvities including swimming" .
"lessons.<P>I/We assume all risks and hazards incidental to participation in" .
"such activities and do hereby waive release, absolve, indemnify, and agree" .
"to hold harmless Kids' Aquatic Center, Inc., their officers, agents, employees," .
"sponsors, volunteers, and participants from any liability or damages which" .
"may arise in connection with participation.</blockquote></TD></TR></TABLE>" .
"<center><TABLE><TR><TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood" .
"the above statement..</TD><TD ROWSPAN=2 BGCOLOR=#FF4480>   " .
"<INPUT TYPE=CHECKBOX NAME=WRAgreement><BR></TD></TR></TABLE><BR>" .
"<TABLE border="1" bgcolor="#101488"><TR><TD ROWSPAN=2 BGCOLOR=#B8CCF8>" .
"<B>Medical Release:</B> <BR><blockquote>I/We, as parent(s)/guardian(s)," .
"grant permission for any emergency treatment deemed necessary to insure" .
"the health, well being, and safety of the above named student. <P>" .
"I/We authorize any hospital, physician, and/or paramedic to perform medical" .
"treatments necessary to insure the health, well-being, and safety of the above" .
"named student.</blockquote></TD></TR></TABLE><TABLE><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood the above statement..</TD>" .
"<TD ROWSPAN=2 BGCOLOR=#FF4480>   <INPUT TYPE=CHECKBOX NAME=MRAgreement>" .
"<BR></TD></TR></TABLE><BR><TABLE border="1" bgcolor="#101488"><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#B8CCF8><B>Receipt and Acceptance of KACI Policies" .
"& Guidelines:</B><BR><blockquote>I/We, as parent(s)/guardian(s), agree to" .
"adhere to all KACI Policies & Guidelines.<P>I/We Understand that tuition" .
"will be due if notice is not received.<P>I/We understand that there are" .
"NO MAKE-UPS or REFUNDS. Our classes are limited. If you cancel for <B>" .
"any reason</B> prior to your swim session, we will refund your payment" .
"less a $25 cancellation fee.</blockquote></TD></TR></TABLE><TABLE><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood the above statement..</TD>" .
"<TD ROWSPAN=2 BGCOLOR=#FF4480>   <INPUT TYPE=CHECKBOX NAME=RAAgreement>" .
"<BR></TD></TR></TABLE><BR></center><P><BR><TABLE><TR><TD BGCOLOR=#B8CCF8>" .
"<BIG>How did you learn about the <FONT STYLE="font-family:Tempus Sans ITC">" .
"<B>Kids' Aquatic Center?</B></BIG></TD></TR><TR>" .
"<TD><B>Choose the following: </B><SELECT NAME=Referral><OPTION>A Friend" .
"<OPTION>A Parent<OPTION>Walk-In<OPTION>Doctors Office<OPTION>Phone Book" .
"<OPTION>Ad<OPTION>Other.........</TR><TR><TD><B>Name of the referral </B>" .
"<INPUT NAME=REFRL></TD></TR></TABLE><BR><BR><TABLE><TR><TD ALIGN=CENTER>" .
"<INPUT TYPE=SUBMIT VALUE=\"SUBMIT\"</TD><TD ALIGN=CENTER>" .
"<INPUT TYPE=RESET VALUE=\"RESET\"</TD></TD></TR></TABLE>" .
"<Input type=\"hidden\" name=\"Visited\" value=\"$Visited\">" .
"<P><BR><BR><P><CENTER>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/backfloatsurvival.jpg" HEIGHT="239" WIDTH="269"></CENTER>" .
"<P> <BR> <P><BR><P><BR><FONT SIZE="-1" color="Gray">" .
"Copyright © 2002-2003 Kids Aquatic Center, Inc. <BR>All Rights" .
"Reserved. Images on this website may not be put as part of ANY collection" .
"without prior written permission. <BR>Web Design & Maintenance" .
"By: <A TARGET="_BLANK" HREF="http://www.rickityrackshack.com/gnoc/home.htm">" .
"GNOC Web Design</A></FONT></P></TD></TR></TABLE></BODY></HTML>";
echo "$form_block";
exit;
}

if ($ChildFrstName == "" || $ChildLstName == "" || $BDate == "" || $Address1 == "" || $City == "" || $State == "" || $Zip == "" || $Mom1stName == "" || $MomsLastName == "" || $Dad1stName == "" || $DadsLastName == "" || $EmerContact == "" || $EmerCntctPhn == "" || $Relation == "" || $WRAgreement == "" || $MRAgreement == "" || $RAAgreement == "")
{
$error_block = "<p><center><font color=red>The Following Fields were missing:<br>";

if($ChildFrstName == "")
$error_block .= "<dd>Child's First Name Missing<br>";
if($ChildLstName == "")
$error_block .= "<dd>Child's Last Name Missing<br>";
if($BDate == "")
$error_block .= "<dd>Child's Birth Date Missing<br>";
if($Address1 == "")
$error_block .= "<dd>First Address Line Missing<br>";
if($City == "")
$error_block .= "<dd>City Missing<br>";
if($State == "")
$error_block .= "<dd>State Missing<br>";
if($Zip == "")
$error_block .= "<dd>Zip Code Missing<br>";
if($Mom1stName == "")
$error_block .= "<dd>Mom's First Name Missing<br>";
if($MomsLastName == "")
$error_block .= "<dd>Mom's Last Name Missing<br>";
if($Dad1stName == "")
$error_block .= "<dd>Dad's First Name Missing<br>";
if($DadsLastName == "")
$error_block .= "<dd>Dad's Last Name Missing<br>";
if($EmerContact == "")
$error_block .= "<dd>Emergency Contact Name Missing<br>";
if($EmerCntctPhn == "")
$error_block .= "<dd>Emergency Contact Phone Missing<br>";
if($Relation == "")
$error_block .= "<dd>Emergency Contact's Relationship to Child Missing<br>";
if($WRAgreement == "")
$error_block .= "<dd>Read and Agree with First Agreement Clause<br>";
if($MRAgreement == "")
$error_block .= "<dd>Read and Agree with Second Agreement Clause<br>";
if($RAAgreement == "")
$error_block .= "<dd>Read and Agree with Third Agreement Clause<br>";

$error_block .= "</font></center></p>";

$form_block="<HTML><HEAD><TITLE>Water survival training for babies, toddlers and children :: Kids Aquatic Center ::</TITLE>" .
"<STYLE TYPE="text/css">a:link { color: blue; text-decoration: underline }" .
"a:active { color: red; text-decoration: none }a:visited { color: blue; text-decoration: none }" .
"a:hover { color: red; text-decoration: underline; background: #F9EDED }" .
"</STYLE> </HEAD><BODY bgcolor="#F2F6FD" topmargin="0" leftmargin="0" marginheight="0" marginwidth="0" TEXT="Black">" .
"<script type='text/javascript' src='http://www.kidsaquaticcenter.com/noclickbubbles.js'></script>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/Kacilogo1.gif" HEIGHT="92" WIDTH="132">" .
"<IMG SRC="http://www.kidsaquaticcenter.com/KACI_logo2.gif" HEIGHT="85" WIDTH="500">" .
"<H2><CENTER><B><FONT FACE="Arial" SIZE="5">K.A.C.I. - Teaching Infant, Toddler and Kids <BR>" .
"Advanced Water Survival since 1979</FONT></H2></CENTER></H2>" .
"<TABLE width="95%" border="0" cellpadding="15" cellspacing="0"><TR ><TD width="10%">" .
"<script type='text/javascript' >//HV Menu v5.411- by Ger Versluis (http://www.burmees.nl/)" .
"//Submitted to Dynamic Drive (http://www.dynamicdrive.com)//Visit http://www.dynamicdrive.com for this script and more" .
"function Go(){return}</script><script type='text/javascript' src='http://www.kidsaquaticcenter.com/kacimenu_var.js'></script>" .
"<script type='text/javascript' src='http://www.kidsaquaticcenter.com/menu_com.js'></script>" .
"<noscript>Your browser does not support script</noscript>" .
"<CENTER><FONT FACE="Arial"><IMG SRC="http://www.kidsaquaticcenter.com/nullpix.gif" HEIGHT="450" WIDTH="2">" .
"Member<IMG SRC="http://www.kidsaquaticcenter.com/NSSA.jpg" HEIGHT="73" WIDTH="92">" .
"<IMG SRC="http://www.kidsaquaticcenter.com/nullpix.gif" HEIGHT="100" WIDTH="2">" .
"</CENTER><FONT SIZE="-2"><a href="http://www.kidsaquaticcenter.com/">Home</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/philosophy.htm">About KACI</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/newsletter.htm">Newsletter</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/preregistration.htm">Pre-registration Form</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/picturegallery.htm">Picture Gallery</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/sitemap.htm">Site Map</a><BR>" .
"<a href="http://www.kidsaquaticcenter.com/guestbook.htm">Guestbook</a><BR>" .
"</FONT></FONT></TD><TD><CENTER>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/Kinleysittingonside.jpg" HEIGHT="211" WIDTH="122">" .
"               " .
"<IMG SRC="http://www.kidsaquaticcenter.com/zach_dive_b.jpg" HEIGHT="211" WIDTH="126">" .
"</CENTER><P><FONT FACE="Arial" SIZE="3"><FONT COLOR="#5008B8" SIZE="+1"><B>" .
"PRE-REGISTRATION INFORMATION:</B></FONT>" .
"$error_block" .
"<P>Please keep in mind that after" .
"submitting this pre-registration form, a timeslot is not confirmed until" .
"you are contacted with the day and time. All forms submitted will be" .
"processed and students are <U><B>then put on a waiting list</B></U>" .
"in the order that the forms are received.<BR><P>" .
"<FORM NAME=REG ACTION=\"contactus.php\" METHOD=POST>" .
"<TABLE ALIGN=CENTER BORDER=4 CELLSPACING=2><CAPTION ALIGN=TOP>" .
"<BIG><BIG>Student Information</BIG></BIG></CAPTION><HR SIZE="2" WIDTH="100%" ALIGN="CENTER">" .
"<TR><TD WIDTH=110>First Name:</TD><TD><INPUT NAME=ChildFrstName SIZE=20 MAXLENGTH=20>" .
"Last Name: <INPUT NAME=ChildLstName SIZE=20 MAXLENGTH=20></TD></TR><TR>" .
"<TD WIDTH=110>Birth Date: </TD><TD><INPUT NAME=BDate SIZE=10 MAXLENGTH=10>" .
"<SMALL><SMALL><B>(Example:01/01/2002)</B></SMALL></SMALL>Phone:" .
"<INPUT NAME=HomePhone SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Address 1:</TD>" .
"<TD><INPUT NAME=Address1 SIZE=55 MAXLENGTH=55></TD></TR><TR><TD WIDTH=110>Address 2:</TD>" .
"<TD><INPUT NAME=Address2 SIZE=55 MAXLENGTH=55></TD></TR><TR><TD WIDTH=110>City:</TD>" .
"<TD><INPUT NAME=City SIZE=10 MAXLENGTH=10>State: <INPUT NAME=State SIZE=2 MAXLENGTH=2>" .
"Zip: <INPUT NAME=Zip SIZE=5 MAXLENGTH=5></TD></TR></TABLE>" .
"<TABLE ALIGN=CENTER BORDER=4 CELLSPACING=2 CELLPADDING="2"><BR><CAPTION VALIGN=MIDDLE>" .
"<BR><BIG><BIG> Parent Information</BIG></BIG></CAPTION><BR>" .
"<HR SIZE="2" WIDTH="100%" ALIGN="CENTER"><TR><TD WIDTH=110>Mom's Name:</TD>" .
"<TD>First:<INPUT NAME=Mom1stName SIZE=20 MAXLENGTH=20><BR>Last:" .
"<INPUT NAME=MomsLastName SIZE=20 MAXLENGTH=20></TD></TR><TR><TD WIDTH=110>Employer: </TD>" .
"<TD><INPUT NAME=MomsEmployer SIZE=25 MAXLENGTH=25>Phone:" .
"<INPUT NAME=MomWkPhn SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Dad's Name:</TD>" .
"<TD>First:<INPUT NAME=Dad1stName SIZE=20 MAXLENGTH=20><BR>Last:" .
"<INPUT NAME=DadsLastName SIZE=20 MAXLENGTH=20></TD></TR><TR><TD WIDTH=110>Employer: </TD>" .
"<TD><INPUT NAME=DadsEmployer SIZE=25 MAXLENGTH=25>Phone:" .
"<INPUT NAME=DadWkPhn SIZE=12 MAXLENGTH=12></TD></TR><TR><TD WIDTH=110>Emergency Contact:<BR>" .
"<SMALL><B>*Other than<BR> parent(s)</B></SMALL></TD><TD>Name:" .
"<INPUT NAME=EmerContact SIZE=25 MAXLENGTH=25><BR>Phone:" .
"<INPUT NAME=EmerCntctPhn SIZE=12 MAXLENGTH=12><BR>Relation:" .
"<INPUT NAME=Relation SIZE=25 MAXLENGTH=25></TD></TR><TR><TD WIDTH=110>Special needs:</TD>" .
"<TD><textarea name="SpNeeds" cols="50" rows="2" wrap="soft"></textarea>" .
"<SMALL><B>* Medical info, physical limitations, etc.</B></SMALL></TD></TR><TR>" .
"<TD>Family Physician: </TD><TD><INPUT NAME=Doctor SIZE=30 MAXLENGTH=30>" .
"Phone: <INPUT NAME=DocPhone SIZE=12 MAXLENGTH=12</TD></TR></TABLE><BR>" .
"<FONT STYLE="font-family:Book Antiqua, Comic Sans MS, Tempus Sans ITC">" .
"<TABLE border="1" bgcolor="#101488"><TR><TD ROWSPAN=2 BGCOLOR=#B8CCF8>" .
"<CENTER><BR><B><U>AFFIRMATION/LIABILITY RELEASE AND EXPRESS ASSUMPTION" .
"OF RISK</U></B></CENTER><BR><B>Waiver & Release:</B> <BR><blockquote>" .
"I/We, as parent(s)/guardian(s), authorize the participation of the above named" .
"student in any and all Kids' Aquatic Center, Inc. actvities including swimming" .
"lessons.<P>I/We assume all risks and hazards incidental to participation in" .
"such activities and do hereby waive release, absolve, indemnify, and agree" .
"to hold harmless Kids' Aquatic Center, Inc., their officers, agents, employees," .
"sponsors, volunteers, and participants from any liability or damages which" .
"may arise in connection with participation.</blockquote></TD></TR></TABLE>" .
"<center><TABLE><TR><TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood" .
"the above statement..</TD><TD ROWSPAN=2 BGCOLOR=#FF4480>   " .
"<INPUT TYPE=CHECKBOX NAME=WRAgreement><BR></TD></TR></TABLE><BR>" .
"<TABLE border="1" bgcolor="#101488"><TR><TD ROWSPAN=2 BGCOLOR=#B8CCF8>" .
"<B>Medical Release:</B> <BR><blockquote>I/We, as parent(s)/guardian(s)," .
"grant permission for any emergency treatment deemed necessary to insure" .
"the health, well being, and safety of the above named student. <P>" .
"I/We authorize any hospital, physician, and/or paramedic to perform medical" .
"treatments necessary to insure the health, well-being, and safety of the above" .
"named student.</blockquote></TD></TR></TABLE><TABLE><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood the above statement..</TD>" .
"<TD ROWSPAN=2 BGCOLOR=#FF4480>   <INPUT TYPE=CHECKBOX NAME=MRAgreement>" .
"<BR></TD></TR></TABLE><BR><TABLE border="1" bgcolor="#101488"><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#B8CCF8><B>Receipt and Acceptance of KACI Policies" .
"& Guidelines:</B><BR><blockquote>I/We, as parent(s)/guardian(s), agree to" .
"adhere to all KACI Policies & Guidelines.<P>I/We Understand that tuition" .
"will be due if notice is not received.<P>I/We understand that there are" .
"NO MAKE-UPS or REFUNDS. Our classes are limited. If you cancel for <B>" .
"any reason</B> prior to your swim session, we will refund your payment" .
"less a $25 cancellation fee.</blockquote></TD></TR></TABLE><TABLE><TR>" .
"<TD ROWSPAN=2 BGCOLOR=#F8D8A8>I have read and understood the above statement..</TD>" .
"<TD ROWSPAN=2 BGCOLOR=#FF4480>   <INPUT TYPE=CHECKBOX NAME=RAAgreement>" .
"<BR></TD></TR></TABLE><BR></center><P><BR><TABLE><TR><TD BGCOLOR=#B8CCF8>" .
"<BIG>How did you learn about the <FONT STYLE="font-family:Tempus Sans ITC">" .
"<B>Kids' Aquatic Center?</B></BIG></TD></TR><TR>" .
"<TD><B>Choose the following: </B><SELECT NAME=Referral><OPTION>A Friend" .
"<OPTION>A Parent<OPTION>Walk-In<OPTION>Doctors Office<OPTION>Phone Book" .
"<OPTION>Ad<OPTION>Other.........</TR><TR><TD><B>Name of the referral </B>" .
"<INPUT NAME=REFRL></TD></TR></TABLE><BR><BR><TABLE><TR><TD ALIGN=CENTER>" .
"<INPUT TYPE=SUBMIT VALUE=\"SUBMIT\"</TD><TD ALIGN=CENTER>" .
"<INPUT TYPE=RESET VALUE=\"RESET\"</TD></TD></TR></TABLE>" .
"<Input type=\"hidden\" name=\"Visited\" value=\"$Visited\">" .
"<P><BR><BR><P><CENTER>" .
"<IMG SRC="http://www.kidsaquaticcenter.com/backfloatsurvival.jpg" HEIGHT="239" WIDTH="269"></CENTER>" .
"<P> <BR> <P><BR><P><BR><FONT SIZE="-1" color="Gray">" .
"Copyright © 2002-2003 Kids Aquatic Center, Inc. <BR>All Rights" .
"Reserved. Images on this website may not be put as part of ANY collection" .
"without prior written permission. <BR>Web Design & Maintenance" .
"By: <A TARGET="_BLANK" HREF="http://www.rickityrackshack.com/gnoc/home.htm">" .
"GNOC Web Design</A></FONT></P></TD></TR></TABLE></BODY></HTML>";
echo "$form_block";
exit;
}

//Changed the information to be sent
$msg = "E-MAIL SENT FROM WWW SITE\n";
$msg .= "Student Information: $ChildFrstName $ChildLstName\n";
$msg .= "Birthdate: $BDate\nPhone: $HomePhone\n";
$msg .= "Address: $Address1\n";
$msg .= " $Address2\n";
$msg .= " $City, $State $Zip\n";

$msg .= "\n\nParent Information:\n";
$msg .= " Mom's Name: $Mom1stName $MomsLastName\n";
$msg .= " Employer: $MomsEmployer Phone: $MomWkPhn\n\n";
$msg .= " Dad's Name: $Dad1stName $DadsLastName\n";
$msg .= " Employer: $DadsEmployer Phone: $DadWkPhn\n\n";

$msg .= "\nEmergency Contact: $EmerContact\n";
$msg .= "Phone: $EmerCntctPhn\n";
$msg .= "Relation: $Relation\n";

$msg .= "\nSpecial Needs: \n";
$msg .= " $SpNeeds\n";

$msg .= "\nFamily Physician: $Doctor\n";
$msg .= "Phone: $DocPhone\n";

$msg .= "Learned about the Web Site by: $Referral\n";
$msg .= "Name of Referral: $REFRL\n";

//$to = "mascott@cox.net";
$to = "kaciswim@cox.net";
$subject = "Web hosting query";
// There was an Error on the next line!!!
$mailheaders = "From: www.kidsaquaticcenter.com\n";
$mailheaders .= "Reply-To: $Email\n";

mail($to, $subject, $msg, $mailheaders);
?>

<HTML>
<HEAD>
<TITLE>
Confirmation Page
</TITLE>
<BODY>
<H1>
The Following Information was sent:
</H1>
<? echo nl2br("$msg"); ?>
</BODY>
</HTML>

April 27th, 2003, 12:37 PM

Darrin Ward

Founder, SEOChat.com :)

Join Date: Dec 2002

Location: Miami, Florida

Posts: 1,439

Time spent in forums: 17 h 5 m 20 sec
Reputation Power: 12

Does it have to be PHP? If it's only a contact for then you may wish to redo the entire script in something that you are more proficient in, such as PERL? I too am pretty bad at PHP so I personally can't shed much light on this

This seems to be mostly HTML with very little code, I think a form handling script such as the BNBFORM Script will be easier.

__________________
Darrin J. Ward, a Professional SEO Consultant and Original Founder of SEO Chat (this site), Google Dance Tool & some other cool stuff!

* Rankings Reporter - Track your Website's Keyword Rankings in Google & Yahoo.

* ChatButton - Free AJAX Chatboxes to embed onto any Webpage - super-easy copy/paste setup!.

April 27th, 2003, 01:41 PM

Lanndshark

Junior Member

Join Date: Mar 2003

Location: Phoenix, AZ USA

Posts: 10

Time spent in forums: < 1 sec
Reputation Power: 0

Darrin,

Duh!

Now why didn't I think of that??? I'm changing her site so I can do anything that I need to as long as I can get the info to her via e-mail! I'll look at the BNB script later on today - thanks for the thought!

And to RustyBrick, I got your e-mail and thank you too! This site rocks with helpful folks!

Dr. Larry

April 29th, 2003, 01:28 PM

Lanndshark

Junior Member

Join Date: Mar 2003

Location: Phoenix, AZ USA

Posts: 10

Time spent in forums: < 1 sec
Reputation Power: 0

I think that I got the PHP code working to my satisfaction. Thanks for the ideas and offers of help!

Dr. Larry

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