Here is my PHP form
<?php
$subject = $name . " - FUTSOC Summer Soccer Program";
$name = $_POST["name"];
$sex = $_POST['sex'];
$age = $_POST["age"];
$birthdate = $_POST["birthdate"];
$grade = $_POST["grade"];
$school = $_POST["school"];
$exptype = $_POST["exptype"];
$expyears = $_POST["expyears"];
$insurance = $_POST["insurance"];
$insphone = $_POST["insphone"];
$physician = $_POST["physician"];
$physphone = $_POST["physphone"];
$medcon = $_POST["medcon"];
$medicalconditions = $_POST["medicalconditions"];
$mothername = $_POST["mothername"];
$motheremail = $_POST["motheremail"];
$motherwork = $_POST["motherwork"];
$mothercell = $_POST["mothercell"];
$motherhome = $_POST["motherhome"];
$motheremployment = $_POST["motheremployment"];
$motheraddress = $_POST["motheraddress"];
$motherpickup = $_POST["motherpickup"];
$fathername = $_POST["fathername"];
$fatheremail = $_POST["fatheremail"];
$fatherwork = $_POST["fatherwork"];
$fathercell = $_POST["fathercell"];
$fatherhome = $_POST["fatherhome"];
$fatheremployment = $_POST["fatheremployment"];
$fatheraddress = $_POST["fatheraddress"];
$fatherpickup = $_POST["fatherpickup"];
$emergencyname1 = $_POST["emergencyname1"];
$emegencyphone1 = $_POST["emegencyphone1"];
$emergencyname2 = $_POST["emergencyname2"];
$emegencyphone2 = $_POST["emegencyphone2"];
$halforfull = $_POST["halforfull"];
$plan = $_POST["plan"];
foreach($_POST['week'] as $value) {
$week .= "$value";
}
$other = $_POST["other"];
$name = stripslashes($name);
$email = stripslashes($email);
$mothername = stripslashes($mothername);
$motheremail = stripslashes($motheremail);
$fathername = stripslashes($fathername);
$fatheremail = stripslashes($fatheremail);
$message = "
Name: $name \n
Sex: $sex \n
Age: $age \n
Birth Date: $birthdate \n
Grade: $grade \n
School: $school \n
Insurance: $insurance \n
Insurance Phone:$insphone \n
Physician:$physician \n
Physician Phone:$physphone \n
Medican Condition: $medcon \n
Other Medical Conditions: $medicalconditions \n
Mother: $mothername \n
E-Mail: $motheremail \n
Work Phone: $motherwork \n
Cell Phone: $mothercell \n
Home Phone: $motherhome \n
Employment: $motheremployment \n
Address: $motheraddress \n
Mother Permitted to pick up participant(s): $motherpickup \n
Father: $fathername \n
E-Mail: $fatheremail \n
Work Phone: $fatherwork \n
Cell Phone: $fathercell \n
Home Phone: $fatherhome \n
Employment: $fatheremployment \n
Address: $fatheraddress \n
Father Permitted to pick up participant(s): $fatherpickup \n
Emergency Contact #1: $emergencyname1 \n
Phone Number: $emegencyphone1 \n
Emergency Contact #1: $emergencyname2 \n
Phone Number: $emegencyphone2 \n
Half Day or Full Day: $halforfull \n
Plan: $plan \n
Weeks: $week \n
Other Dates: $other \n
";
$from = "From: $motheremail";
mail("youremail@yourhost.com", $subject, $message, $from);
header ("location:http://www.futsocusa.net/fundingsummer.html");
?>
This post has been edited by CTphpnwb: 03 May 2012 - 02:01 PM

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