supermarkt-cadeaubon.prijzenfestijn.com Open in urlscan Pro
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Form analysis
1 forms found in the DOM

Name: user_data_form — POST /

<form name="user_data_form" method="post" action="/" id="user_data_form" novalidate="novalidate">
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        aria-required="true">Man</label><input type="radio" id="user_data_form_gender_1" name="user_data_form[gender]" required="required" value="MRS" aria-required="true"><label for="user_data_form_gender_1" class="required"
        aria-required="true">Vrouw</label></div>
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  <div id="user_data_form_block_firstName" class="form-group">
    <input type="text" id="user_data_form_firstName" name="user_data_form[firstName]" required="required" placeholder="Voornaam" autocomplete="off" aria-required="true">
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    <input type="text" id="user_data_form_lastName" name="user_data_form[lastName]" required="required" placeholder="Achternaam" autocomplete="off" aria-required="true">
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  <div id="user_data_form_block_email" class="form-group">
    <input type="email" id="user_data_form_email" name="user_data_form[email]" required="required" placeholder="Email" autocomplete="off" aria-required="true">
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    <label class="required" aria-required="true">Geboortedatum:</label>
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        <option value="" selected="selected">Dag</option>
        <option value="1">01</option>
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        <option value="29">29</option>
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        <option value="" selected="selected">Maand</option>
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        <option value="2">Februari</option>
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        <option value="5">Mei</option>
        <option value="6">Juni</option>
        <option value="7">Juli</option>
        <option value="8">Augustus</option>
        <option value="9">September</option>
        <option value="10">Oktober</option>
        <option value="11">November</option>
        <option value="12">December</option>
      </select><select id="user_data_form_birthdate_year" name="user_data_form[birthdate][year]" required="required" aria-required="true">
        <option value="" selected="selected">Jaar</option>
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        <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>
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        <option value="1990">1990</option>
        <option value="1989">1989</option>
        <option value="1988">1988</option>
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        <option value="1986">1986</option>
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        <option value="1984">1984</option>
        <option value="1983">1983</option>
        <option value="1982">1982</option>
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        <option value="1980">1980</option>
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        <option value="1970">1970</option>
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        <option value="1964">1964</option>
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        <option value="1961">1961</option>
        <option value="1960">1960</option>
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        <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>
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        <option value="1942">1942</option>
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        <option value="1940">1940</option>
        <option value="1939">1939</option>
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        <option value="1937">1937</option>
        <option value="1936">1936</option>
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  </div>
  <div id="user_data_form_block_signUpOne" class="form-group">
    <div class="checkbox group terms" style="padding-top:10px">
      <label><b>Ja, ik heb dit gelezen en ga akkoord met de <a href="/461/terms-and-conditions.html" class="fancybox fancybox.iframe" data-toggle="modal">Algemene Voorwaarden</a> en <a href="/461/privacy.html" class="fancybox fancybox.iframe" data-toggle="modal">Privacyverklaring</a></b></label>
    </div>
    <div class="checkbox group terms"><label class="terms_sponsor"><input id="agree" name="agree" type="checkbox" required="">Ja, ik ga akkoord om communicatie te ontvangen voor reclame- en telemarketingdoeleinden (e-mail/telefoon) van bedrijven die
        worden vermeld in de <a href="/sponsors.html" class="fancybox fancybox.iframe" data-toggle="modal" data-target="#modal-legal">sponsorlijst</a> Klik op de sponsorlijst om jouw communicatievoorkeuren te wijzigen. Je kan meedoen zonder
        communicatie te ontvangen. Jouw toestemming kan elk moment worden ingetrokken zonder consequenties.</label></div>
    <button type="submit" id="user_data_form_signUpOne" name="user_data_form[signUpOne]" autocomplete="off">GA VERDER &gt;&gt;</button>
  </div>
  <div id="user_data_form_block__token" class="form-group">
    <input type="hidden" id="user_data_form__token" name="user_data_form[_token]" value="TqpgHvsVKOOl2eOT1RLNDjIh7oQlRRqJT4w2CWDQUOA">
  </div>
</form>

Text Content

WIN EEN
€150 JUMBO
CADEAUKAART


WIN EEN
JUMBO CADEAUKAARTT.W.V. € 150,-


VUL AUB JE GEGEVENS IN

ManVrouw



Geboortedatum:
Dag01020304050607080910111213141516171819202122232425262728293031MaandJanuariFebruariMaartAprilMeiJuniJuliAugustusSeptemberOktoberNovemberDecemberJaar20022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926
Ja, ik heb dit gelezen en ga akkoord met de Algemene Voorwaarden en
Privacyverklaring
Ja, ik ga akkoord om communicatie te ontvangen voor reclame- en
telemarketingdoeleinden (e-mail/telefoon) van bedrijven die worden vermeld in de
sponsorlijst Klik op de sponsorlijst om jouw communicatievoorkeuren te wijzigen.
Je kan meedoen zonder communicatie te ontvangen. Jouw toestemming kan elk moment
worden ingetrokken zonder consequenties.
GA VERDER >>


ER ZIJN NOG 14CADEAUKAARTEN OVER. DOE MEE EN WIN!



Het genoemde merk / bedrijf is niet de organisator of sponsor van deze campagne
en is op geen enkele wijze gerelateerd aan de organisatie.

 * Deze actie wordt georganiseerd door Voucherplaza
 * Algemene voorwaarden
 * Privacyverklaring
 * Uitschrijven

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