register.hollywoodbets.net
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Submitted URL: https://wlhollywoodbets.adsrv.eacdn.com/C.ashx?btag=a_188b_73c_&affid=654452&siteid=188&adid=73&c=HPBAJIGDICMANZA
Effective URL: https://register.hollywoodbets.net/south-africa/1?btag=a_188b_73c_HPBAJIGDICMANZA
Submission Tags: falconsandbox
Submission: On November 27 via api from US — Scanned from DE
Effective URL: https://register.hollywoodbets.net/south-africa/1?btag=a_188b_73c_HPBAJIGDICMANZA
Submission Tags: falconsandbox
Submission: On November 27 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
POST /HandleForm/south-africa/1?btag=a_188b_73c_HPBAJIGDICMANZA
<form novalidate="" id="south-africa" method="POST" action="/HandleForm/south-africa/1?btag=a_188b_73c_HPBAJIGDICMANZA" class="mx-2 mt-3">
<div class="row my-2 mx-0">
<div class="col-md">
<h2>Sign Up With Hollywoodbets – Register Below </h2>
<div></div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-md">
<h4>Get a R25 sign up bonus + 50 Free spins on Habanero games once your Hollywoodbets account is activated.</h4>
<div></div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-12 text-danger">
<h6>* Required field</h6>
<div></div>
</div>
</div>
<div class="row mx-0">
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Title <span class="text-danger">*</span></label><label></label></div>
<div class="col-sm-9">
<div><select for="title" name="title" id="title" class="form-select">
<option value="2">Ms</option>
<option value="3">Miss</option>
<option value="4">Mrs</option>
<option value="5">Mr</option>
<option value="6">Dr</option>
</select>
<div id="title-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>First name <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="name" id="name" placeholder="(As appears on ID Card or Book)" type="text" class="form-control">
<div id="name-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Surname <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="surname" id="surname" placeholder="(As appears on ID Card or Book)" type="text" class="form-control">
<div id="surname-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label></label></div>
<div class="col-sm-9"><label class="form-label"></label>
<div id="identityType">
<div id="identityType-error" class="invalid-feedback"></div>
<div class="form-check form-check-inline"><input id="identityType" type="radio" name="identityType" class="form-check-input" value="identityNumber"><label for="identityType" class="form-check-label">ID Number <span
class="text-danger">*</span></label></div>
<div class="form-check form-check-inline"><input id="identityType" type="radio" name="identityType" class="form-check-input" value="passportNumber"><label for="identityType" class="form-check-label">Passport <span
class="text-danger">*</span></label></div>
</div>
</div>
</div>
<div class="col-md">
<div class="row my-2 mx-0">
<div class="col-sm-3"><label></label></div>
<div class="col-sm-9">
<div><input name="identityNumber" id="identityNumber" placeholder="ID Number" type="text" class="form-control">
<div id="identityNumber-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label></label></div>
<div class="col-sm-9">
<div hidden="true"><input name="passportNumber" id="passportNumber" placeholder="Passport Number" type="text" class="form-control">
<div id="passportNumber-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Date of birth <span class="text-danger">*</span></label></div>
<div class="col-sm-3 col-xs-3">
<div><select for="dobDate" name="dobDate" id="dobDate" class="form-select">
<option value="0">Day</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<div id="dobDate-error" class="invalid-feedback"></div>
</div>
</div>
<div class="col-sm-3 col-xs-3">
<div><select for="dobMonth" name="dobMonth" id="dobMonth" class="form-select">
<option value="0">Month</option>
<option value="1">January</option>
<option value="2">February</option>
<option value="3">March</option>
<option value="4">April</option>
<option value="5">May</option>
<option value="6">June</option>
<option value="7">July</option>
<option value="8">August</option>
<option value="9">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select>
<div id="dobMonth-error" class="invalid-feedback"></div>
</div>
</div>
<div class="col-sm-3 col-xs-3">
<div><select for="dobYear" name="dobYear" id="dobYear" class="form-select">
<option value="0">Year</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
<option value="1903">1903</option>
<option value="1902">1902</option>
<option value="1901">1901</option>
<option value="1900">1900</option>
</select>
<div id="dobYear-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Gender <span class="text-danger">*</span></label></div>
<div class="col-sm-9"><label class="form-label"></label>
<div id="gender">
<div id="gender-error" class="invalid-feedback"></div>
<div class="form-check form-check-inline"><input id="gender" type="radio" name="gender" class="form-check-input" value="m"><label for="gender" class="form-check-label">Male</label></div>
<div class="form-check form-check-inline"><input id="gender" type="radio" name="gender" class="form-check-input" value="f"><label for="gender" class="form-check-label">Female</label></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Mobile No <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="mobile" id="mobile" placeholder="0831234567" type="text" class="form-control">
<div id="mobile-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Email</label></div>
<div class="col-sm-9">
<div><input name="email" id="email" placeholder="name@email.com" type="text" class="form-control">
<div id="email-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Address Line 1 <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="addressline" id="addressline" placeholder="" type="text" class="form-control">
<div id="addressline-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Address Line 2</label></div>
<div class="col-sm-9">
<div><input name="addressLineTwo" id="addressLineTwo" placeholder="" type="text" class="form-control">
<div id="addressLineTwo-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Suburb <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="suburb" id="suburb" placeholder="" type="text" class="form-control">
<div id="suburb-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>City <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="city" id="city" placeholder="" type="text" class="form-control">
<div id="city-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Area Code <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="code" id="code" placeholder="" type="text" class="form-control">
<div id="code-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Province <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><select for="province" name="province" id="province" class="form-select">
<option value="2">Gauteng</option>
<option value="3">KwaZulu-Natal</option>
<option value="4">Limpopo</option>
<option value="5">Mpumalanga</option>
<option value="6">Northern Cape</option>
<option value="7">North West</option>
<option value="8">Western Cape</option>
<option value="9">Eastern Cape</option>
<option value="11">Free State</option>
</select>
<div id="province-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Source of income <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><select for="income" name="income" id="income" class="form-select">
<option value="salary">Salary</option>
<option value="selfEmployed">Self Employed</option>
<option value="inheritance">Inheritance</option>
<option value="savings">Savings</option>
<option value="investment">Investment</option>
</select>
<div id="income-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Password <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="password" id="password" placeholder="Min 6, with at least 1 no and 1 letter" type="password" class="form-control">
<div id="password-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Confirm Password <span class="text-danger">*</span></label></div>
<div class="col-sm-9">
<div><input name="Confirm password" id="Confirm password" placeholder="" type="password" class="form-control">
<div id="Confirm password-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>View odds as</label></div>
<div class="col-sm-9"><label class="form-label"></label>
<div id="fractionalOdds">
<div id="fractionalOdds-error" class="invalid-feedback"></div>
<div class="form-check form-check-inline"><input id="fractionalOdds" type="radio" name="fractionalOdds" class="form-check-input" value="true"><label for="fractionalOdds" class="form-check-label">Fractions</label></div>
<div class="form-check form-check-inline"><input id="fractionalOdds" type="radio" name="fractionalOdds" class="form-check-input" value="false"><label for="fractionalOdds" class="form-check-label">Decimal</label></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-1">
<div style="float:right;" class="form-check"><input name="emailPromotions" id="emailPromotions" type="checkbox" value="false" class="form-check-input">
<div id="emailPromotions-error" class="invalid-feedback"></div>
</div>
</div>
<div style="width:90%;" class="col-sm-9"><a>Receive promotional information?</a></div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-1">
<div style="float:right;" class="form-check"><input name="emailNotifications" id="emailNotifications" type="checkbox" value="false" class="form-check-input">
<div id="emailNotifications-error" class="invalid-feedback"></div>
</div>
</div>
<div style="width:90%;" class="col-sm-9"><a>Receive betting Confirmation via Email?</a></div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-1">
<div style="float:right;" class="form-check"><input name="agePolicy" id="agePolicy" type="checkbox" value="true" class="form-check-input">
<div id="agePolicy-error" class="invalid-feedback"></div>
</div>
</div>
<div style="width:90%;" class="col-sm-9"><a><span class="text-danger">*</span>I am over 18 years of age</a></div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-1">
<div style="float:right;" class="form-check"><input name="termsAndConditions" id="termsAndConditions" type="checkbox" value="true" class="form-check-input">
<div id="termsAndConditions-error" class="invalid-feedback"></div>
</div>
</div>
<div style="width:90%;" class="col-sm-9"><label class="form-label"><span class="text-danger">*</span> I agree to the
</label><a id="termsAndConditionsLink" href="https://m.hollywoodbets.net/content/7/isLoggedIn/false/35" target="_blank">Terms & Conditions</a><label class="form-label"> ,and
</label><a id="dislclaimerLink" href="https://m.hollywoodbets.net/content/919/isLoggedIn/false" target="_blank"> Disclaimer</a></div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-1">
<div style="float:right;" class="form-check"><input name="checkFunds" id="checkFunds" type="checkbox" value="true" class="form-check-input">
<div id="checkFunds-error" class="invalid-feedback"></div>
</div>
</div>
<div style="width:90%;" class="col-sm-9">
<a><span class="text-danger">*</span> I acknowledge that Hollywoodbets can only release funds to me via cash from one of its branches, via our four Cash Send options or into a South African Bank account via EFT</a></div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-12"><label>Referred by a friend? <br> Enter referrer's Hollywoodbets acc number</label></div>
<div class="col-sm-12">
<div><input name="referFriendAccNo" id="referFriendAccNo" placeholder="Optional" type="text" class="form-control">
<div id="referFriendAccNo-error" class="invalid-feedback"></div>
</div>
</div>
</div>
<div class="row my-2 mx-0">
<div class="col-sm-3"><label>Promo Code</label></div>
<div class="col-sm-9">
<div class="promo-code"><input name="promoCode" id="promoCode" placeholder="Optional" type="text" class="form-control">
<div id="promoCode-error" class="invalid-feedback"></div>
</div>
<div class="error-promo-code invalid-feedback display-none">undefined</div>
</div>
</div>
<div class="row mx-0">
<div class="row my-2 mx-0">
<div class="col-md">
<div><input id="recaptcha" name="recaptcha" type="hidden">
<div data-callback="GRecaptcha" data-error-callback="GRecaptcha" data-expired-callback="GRecaptcha" data-sitekey="6Lfp3wQkAAAAALFAg7344sJNEJw_gPiRNShJfw-P" data-theme="white" required="required" class="g-recaptcha">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-iasd2ggjws6q" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lfp3wQkAAAAALFAg7344sJNEJw_gPiRNShJfw-P&co=aHR0cHM6Ly9yZWdpc3Rlci5ob2xseXdvb2RiZXRzLm5ldDo0NDM.&hl=de&v=pPK749sccDmVW_9DSeTMVvh2&theme=white&size=normal&cb=9hssx62cpetu"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<div id="recaptcha-error" class="invalid-feedback"></div>
</div>
</div>
</div>
</div>
<div class="col-sm-9">
<div hidden="true"><input name="iovationBB" id="iovationBB" placeholder="" type="hidden" class="form-control"
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SIGN UP WITH HOLLYWOODBETS – REGISTER BELOW GET A R25 SIGN UP BONUS + 50 FREE SPINS ON HABANERO GAMES ONCE YOUR HOLLYWOODBETS ACCOUNT IS ACTIVATED. * REQUIRED FIELD Title * MsMissMrsMrDr First name * Surname * ID Number * Passport * Date of birth * Day12345678910111213141516171819202122232425262728293031 MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year20062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Gender * Male Female Mobile No * Email Address Line 1 * Address Line 2 Suburb * City * Area Code * Province * GautengKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern CapeEastern CapeFree State Source of income * SalarySelf EmployedInheritanceSavingsInvestment Password * Confirm Password * View odds as Fractions Decimal Receive promotional information? Receive betting Confirmation via Email? *I am over 18 years of age * I agree to the Terms & Conditions ,and Disclaimer * I acknowledge that Hollywoodbets can only release funds to me via cash from one of its branches, via our four Cash Send options or into a South African Bank account via EFT Referred by a friend? Enter referrer's Hollywoodbets acc number Promo Code undefined X ERROR : OTP Verification Submit Already have an account? Sign in HOLLYWOOD SPORTSBOOK IS A LICENSED BETTING OPERATOR. HOLLYWOODBETS SUPPORTS RESPONSIBLE GAMBLING. NO PERSONS UNDER THE AGE OF 18 YEARS ARE PERMITTED TO GAMBLE. WINNERS KNOW WHEN TO STOP. SOUTH AFRICAN RESPONSIBLE GAMBLING FOUNDATION TOLL-FREE COUNSELLING LINE 0800 006 008 OR WHATSAPP HELP TO 076 675 0710. RESEND Enter OTP Check your SMS's for OTP Submit RESEND CLICK RESEND TO RECEIVE A NEW OTP YOU HAVE REACHED THE MAXIMUM NUMBER OF ATTEMPTS, YOU WILL NOW BE REDIRECTED TO THE REGISTRATION PAGE