I noticed 2 things.
First:
PHP Code:
$retvars .= "message:".$vbulletin->GPC['message'].":<br />";
You have that but not registered it for use in the template.
Second:
In your template I notice you have the form pointing to the same file that you are using to fill out this form. Am I mistaken that maybe you didn't give the process form location.
Also I noticed that you don't have this in your file:
PHP Code:
define('GET_EDIT_TEMPLATES', true);
With your submit button, try this instead:
HTML Code:
<input name="submit" class="button" type="submit" id="save" value="submit" />