$val) {if(is_array($_POST[$key])) $_POST[$key] = implode(", ", $_POST[$key]);}} $form15=$_POST['form15'];if($_SERVER["REQUEST_METHOD"] == "POST") { foreach($_POST as $key => $val) {if(is_array($_POST[$key])) $_POST[$key] = implode(", ", $_POST[$key]);}} $form16=$_POST['form16'];if($_SERVER["REQUEST_METHOD"] == "POST") { foreach($_POST as $key => $val) {if(is_array($_POST[$key])) $_POST[$key] = implode(", ", $_POST[$key]);}} $form19=$_POST['form19'];$form20 = strip_tags($_REQUEST['form20']); $form21 = strip_tags($_REQUEST['form21']); $form23 = strip_tags($_REQUEST['form23']); $headers="From:rtksellars@gmail.com\r\nCC:ctcm@bigpond.com\r\nContent-type:text/html\r\n"; mail('rtksellars@gmail.com', 'Feedback from Entry Form', 'ENTRY FORM

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TOWN/CITY:

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POSTCODE:

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PHONE:

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EMAIL:

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DATE OF BIRTH:

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MEDIA RELEASE

As an entrant in the 2017 Charters Towers Country Music Festival, I hereby give my permission for my photograph or my child's photograph, taken over the duration of the Charters Towers Country Music Festival 28th - 30th April 2017, to be used in media promotions on the Official Website, Facebook, and for any other media release.

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Signature*:

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I/WE:
ADDRESS:
TOWN/CITY:
POSTCODE:
PHONE:
DATE OF BIRTH:
Adult (17 years+) section................................ $30
Youth (11 – 16 years) section......................... $20
Juvenile (10 and under) section..................... $10
Duo/Group section......................................... $20
I have read and understand the 2017 Conditions of Entry
The Registration Officer
Charters Towers Country Music Inc.
P.O. Box 20
Charters Towers QLD 4820
Direct Debit: Charters Towers Country Music Inc.
BSB: 704 640 (Queensland Country Credit Union)
Account No. 001 675 25 (Use surname as reference)
BACKING BAND REQUIREMENTS
Backing Band required:
Yes I require use of the backing band
No I do not require use of the backing band
If you have ticked yes, please ensure you have read the rules regarding supplying chord charts for the bands. The musicians have the right to refuse to back contestants who do not have appropriate chord charts.
(Please sign and include with Entry Form)
As an entrant in the 2017 Charters Towers Country Music Festival, I hereby give my permission for my photograph or my child's photograph, taken over the duration of the Charters Towers Country Music Festival 28th - 30th April 2017, to be used in media promotions on the Official Website, Facebook, and for any other media release.
Signature*:
*By inserting your name in the above space you have provided an electronic signature
Entries Strictly close 21st April 2017
www.charterstowerscountrymusic.com
The Registration Officer
Box 20 Charters Towers Q. 4820
Mobile: 0418717669
EMAIL:
ABN: 53 913 863 285
Charters Towers Country Music Festival Talent Quest
Please register me for the following section (please see Conditions of Entry for further details):
Mail entries with cheque or money order to:
Or, email entries to:
Name:
MEDIA RELEASE
ENTRY FORM
Sections
Competitors Name