17.rewardzinga1.com
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Submitted URL: https://12.rewardzinga1.com/750-door-dash-rewards-v-5-instructional
Effective URL: https://17.rewardzinga1.com/750-door-dash-rewards-v-5-instructional
Submission: On December 17 via api from US — Scanned from US
Effective URL: https://17.rewardzinga1.com/750-door-dash-rewards-v-5-instructional
Submission: On December 17 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
POST /flow?uid=c699e2dc-782a-4d88-b92b-61b0209b36b3
<form id="formSubmit" action="/flow?uid=c699e2dc-782a-4d88-b92b-61b0209b36b3" method="POST" data-effect="" data-effect-duration="">
<div id="f1" class="dynamic-form form-step form1 form1-1">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-1-1-1" class="path-dynamic-field">
<style>
.global-consent {
font-size: 13px !important;
line-height: 1.1;
}
</style>
</div>
<script>
document.querySelector('#path-field-html-1-1-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-1-2-1" class="path-dynamic-field">
<div id="form-progress-bar-container" style="
display: flex;
flex-direction: column;
align-items: center;
padding: 0 0 10px 0;
">
<span id="form-progress-bar-text" style="color: #5a5a5a; font-size: 16px; padding: 0 0 8px 0">Confirming entry to win</span>
<svg xmlns="http://www.w3.org/2000/svg" width="210px" height="7" viewBox="0 0 210 7" fill="none">
<rect x="0.233337" y="0.11908" width="209" height="7" rx="3.19169" fill="#E4E4E4"></rect>
<rect x="0.233337" y="0.11908" width="157.5" height="7" rx="3.19169" fill="#10B210"></rect>
</svg>
</div>
</div>
<script>
document.querySelector('#path-field-html-1-2-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-1-3-1" class="path-dynamic-field">
<div class="headertext">Continue below to proceed</div>
</div>
<script>
document.querySelector('#path-field-html-1-3-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-first_name" class="col first-name form-field-col" data-col-id="1" data-autohide="true">
<label class="label">First Name</label>
<input id="first_name" type="text" name="first_name" class="path-form-field-with-feedback path-dynamic-field required" title="First Name" value="">
<span id="first_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#first_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#first_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('first_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-last_name" class="col last-name form-field-col" data-col-id="1" data-autohide="true">
<label class="label">Last Name</label>
<input id="last_name" type="text" name="last_name" class="path-form-field-with-feedback path-dynamic-field required" title="Last Name" value="">
<span id="last_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#last_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#last_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('last_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="6">
<div id="col-field-email" class="col e-mail-required form-field-col" data-col-id="1" data-autohide="">
<label class="label">E-mail</label>
<input id="email" list="email_domains" type="email" name="email" class="path-form-field-with-feedback path-dynamic-field required" title="Email" data-session-verification="-1" value="">
<span id="emailmessage" class="invalid-feedback hidden path-form-feedback"></span>
<datalist id="email_domains"></datalist>
<script>
document.querySelector('#email').addEventListener('path-dynamic-field-register', function(evt) {
var domains = ["gmail.com", "yahoo.com", "hotmail.com", "aol.com", "hotmail.co.uk", "hotmail.fr", "msn.com", "yahoo.fr", "wanadoo.fr", "orange.fr", "comcast.net", "yahoo.co.uk", "yahoo.co.in", "live.com", "rediffmail.com", "free.fr",
"gmx.de", "web.de", "yandex.ru", "ymail.com", "libero.it", "outlook.com", "uol.com", "bol.com", "mail.ru", "cox.net", "hotmail.it", "sbcglobal.net", "sfr.fr", "live.fr", "verizon.net", "live.co.uk", "googlemail.com", "yahoo.es",
"ig.com", "live.nl", "bigpond.com", "terra.com", "yahoo.it", "neuf.fr", "yahoo.de", "alice.it", "rocketmail.com", "att.net", "laposte.net", "facebook.com", "bellsouth.net", "yahoo.in", "hotmail.es", "charter.net", "yahoo.ca",
"yahoo.com.au", "rambler.ru", "hotmail.de", "tiscali.it", "shaw.ca", "yahoo.co.jp", "sky.com"
]
var feedbackElem = document.querySelector('#emailmessage')
var emailDomains = document.querySelector('#email_domains')
var elem = this
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('input', evt.detail.listener(function(evt, setValue) {
var value = evt.target.value
setValue(value)
var split = value.split('@')
var username = split[0]
var domain = split[1]
var regex = domain && new RegExp('@' + domain)
emailDomains.innerHTML = ''
domains.forEach(function(domain) {
if (regex && regex.test('@' + domain) && username + '@' + domain !== value) {
var option = emailDomains.appendChild(document.createElement('option'))
option.setAttribute('value', username + '@' + domain)
}
})
}))
})
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('test')
evt.detail.assignToState('email', evt.detail.effects.test)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="7">
<div id="col-field-address1" class="col address-1 form-field-col" data-col-id="1" data-autohide="true">
<label class="label">Address 1</label>
<input id="addressform" type="text" name="addressform" title="Address" value="" class="path-dynamic-field path-form-field-with-feedback required" autocomplete="address-line1">
<span id="address1-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-postal"></span>
<input id="address1" type="hidden" name="address1" title="Address" value="">
<script>
document.querySelector('#addressform').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#address1-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('address1')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="8">
<div id="col-field-zip" class="col zip-code form-field-col" data-col-id="1" data-autohide="true">
<label class="label">Zip Code</label>
<input id="zip" type="text" name="zip" title="Zipcode" maxlength="5" data-session-verification="-1" value="" class="path-form-field-with-feedback required path-dynamic-field" pattern="[0-9]*" inputmode="numeric" autocomplete="postal-code">
<span id="zip-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#zip').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#zip-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('zip')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillZip(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
$(elem).change()
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="9">
<div id="col-field-city" class="col city form-field-col" data-col-id="1" data-autohide="true">
<label class="label">City</label>
<input id="city" type="text" name="city" title="City" value="" class="path-form-field-with-feedback path-dynamic-field required" autocomplete="address-level2">
<span id="city-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#city').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#city-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('city')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-state" class="col state form-field-col" data-col-id="2" data-autohide="true">
<label class="label">State</label>
<select id="state" name="state" title="State" class="path-form-field-with-feedback path-dynamic-field required" value="" datavalue="">
<option value=""> Select State </option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<span id="state-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#state').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#state-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('state')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select State
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="10">
<div id="col-field-dob" class="col date-of-birth form-field-col" data-col-id="1" data-autohide="true">
<label class="label">Date of Birth</label>
<div class="row path-form-field-with-feedback-control">
<div class="col">
<select id="dob_month" name="dob_month" title="Dob Month" autocomplete="bday-month" class="path-dynamic-field required">
<option value=""> Month </option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col">
<select id="dob_day" name="dob_day" title="Dob Day" autocomplete="bday-day" class="path-dynamic-field required">
<option value=""> Day </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</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>
<div class="col">
<select id="dob_year" name="dob_year" title="Dob Year" autocomplete="bday-year" class="path-dynamic-field required">
<option value=""> 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>
</select>
</div>
</div>
<span id="dobmessage" class="invalid-feedback hidden path-form-feedback"></span>
<script>
var feedbackElem = document.querySelector('#dobmessage')
document.querySelector('#dob_day').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.assignToState('dob_day', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Day
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_year').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
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evt.detail.assignToState('age')
evt.detail.assignToState('dob_year', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Year
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_month').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
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evt.detail.assignToState('dob_month', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Month
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
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</div>
<div class="row row-spacing" data-row-id="11">
<div id="col-field-gender" class="col gender form-field-col" data-col-id="1" data-autohide="true">
<label class="label">Gender</label>
<select id="gender" data-value="" data-type="gender" name="gender" title="Gender" class="path-form-field-with-feedback path-dynamic-field required">
<option value=""> Select Gender </option>
<option value="M">Male</option>
<option value="F">Female</option>
</select>
<span id="gender-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#gender[data-type=gender]').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#gender-error-feedback')
var elem = this
evt.detail.assignToState('gender')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Gender
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="12">
<div id="col-field-registration_consent" class="col registration-consent form-field-col" data-col-id="1" data-autohide="false">
<div class="terms termschk">
<input type="hidden" class="chkbox path-dynamic-field" id="chkterms" name="chkterms" checked="" value="on">
<label class="term-label terms-label--text">
<div class="global-consent">By clicking Continue, I agree to receive marketing and promotional emails from RewardZinga and our partners. I also agree to the
<a href="/rewards-terms-and-conditions" target="_blank" style="color:#5e8bb8;">Terms & Conditions</a>, including mandatory arbitration, <a href="/rewards-privacy-policy" target="_blank" style="color:#5e8bb8;">Privacy Policy</a> and
site recordation by TrustedForm and Jornaya.</div>
</label>
<script>
document.querySelector('#chkterms').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.assignToState('registrationConsent', function(value) {
elem.dispatchEvent(new CustomEvent('path-event-registration-consent-changed'))
return elem.checked
})
})
</script>
</div>
</div>
</div>
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<div id="col-field-submit" class="col custom-submit-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="btn form-button submitbutton form-submit-button" type="button" id="submitbutton">
<span>Continue</span>
<i class="fa fa-spinner fa-spin"></i>
</button>
</div>
</div>
</div>
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<div class="row row-spacing" data-row-id="1">
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<div id="path-field-html-2-1-1" class="path-dynamic-field">
<div id="form-progress-bar-container" style="
display: flex;
flex-direction: column;
align-items: center;
padding: 0 0 10px 0;
">
<span id="form-progress-bar-text" style="color: #5a5a5a; font-size: 16px; padding: 0 0 8px 0">Confirming entry to win</span>
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</svg>
</div>
</div>
<script>
document.querySelector('#path-field-html-2-1-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-2-2-1" class="path-dynamic-field">
<div class="headertext">Thanks! Please confirm your number</div>
</div>
<script>
document.querySelector('#path-field-html-2-2-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-phone" class="col phone form-field-col" data-col-id="1" data-autohide="">
<label class="label">Phone</label>
<input id="phone" type="tel" name="phone" title="Phone" data-session-verification="-1" value="" class="path-dynamic-field path-form-field-with-feedback required" pattern="[0-9]*" inputmode="numeric" autocomplete="tel-national">
<span id="phone-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-phone"></span>
<script>
document.querySelector('#phone').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#phone-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
evt.detail.assignToState('phone')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInputPhone(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-tcpa_consent" class="col tcpa-consent form-field-col" data-col-id="1" data-autohide="false">
<div class="tcpa-terms">
<input type="hidden" class="chkbox path-dynamic-field" id="leadid_tcpa_disclosure" name="chktcpa" checked="">
<label class="term-label p-0" for="leadid_tcpa_disclosure">
<div class="global-consent">By clicking the “Continue” button, I provide my affirmative consent to receive marketing phone calls and text messages from Unified Marketing Partner LLC regarding healthcare or promotional products or services
on the landline and/or mobile number I provided above even if the phone number provided is on the National Do Not Call registry. Calls may be generated using an autodialer and I can revoke my consent for calls by any reasonable means. I
do not need to provide consent to participate in this program or offers promoted on this website and can <a notcpaconsent="" style="color:#5e8bb8;" href="javascript:void(0)">Click here</a> to continue without providing consent. I also
agree to the <a href="/rewards-terms-and-conditions" target="_blank" style="color:#5e8bb8;">Terms & Conditions</a> (including mandatory arbitration) and
<a href="/rewards-privacy-policy" target="_blank" style="color:#5e8bb8;">Privacy Policy</a>.</div>
</label>
<script>
document.querySelector('#leadid_tcpa_disclosure').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.assignToState('tcpaConsent', function(value) {
return elem.checked
})
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
validation: renders.overrideTcpaConsentAlertText
}
})
})
</script>
</div>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-submit" class="col custom-submit-button form-field-col-ignored" data-col-id="1" data-autohide="">
<button class="btn form-button submitbutton form-submit-button" type="button" id="submitbutton">
<span>Continue</span>
<i class="fa fa-spinner fa-spin"></i>
</button>
</div>
</div>
</div>
<div class="form-row">
<div class="x-12 col-mobile center">
</div>
</div>
<div class="hidden">
<input type="hidden" id="numForms" name="numForms" value="2">
<input type="hidden" id="tcpaStep" name="tcpaStep" value="-1">
<input type="hidden" id="registrationStep" name="registrationStep" value="-1">
<input type="hidden" id="currentForm" name="currentForm" value="1">
<input type="hidden" id="uid" name="uid" value="c699e2dc-782a-4d88-b92b-61b0209b36b3">
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<input type="hidden" id="addressCheck" name="addressCheck" value="false">
<input type="hidden" id="fraudCheck" name="fraudCheck" value="false">
<input type="hidden" id="emailValid" name="emailValid" value="false">
<input type="hidden" id="addressValid" name="addressValid" value="false">
<input type="hidden" name="origin" value="submit">
<input type="hidden" id="haddress1" value="">
<input type="hidden" id="haddress2" value="">
<input type="hidden" id="hcity" value="">
<input type="hidden" id="hstate" value="">
<input type="hidden" id="hzipcode" value="">
<div id="pixel"></div>
<script type="text/javascript">
(function() {
var field = 'xxTrustedFormCertUrl';
var provideReferrer = false;
var invertFieldSensitivity = false;
var tf = document.createElement('script');
tf.type = 'text/javascript';
tf.async = true;
tf.src = 'http' + ('https:' == document.location.protocol ? 's' : '') + '://api.trustedform.com/trustedform.js?field=' + escape(field) + '&l=' + new Date().getTime() + Math.random() + '&invert_field_sensitivity=' + invertFieldSensitivity;
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<noscript>
<img src="//api.trustedform.com/ns.gif">
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<input id="leadid_token" name="universal_leadid" type="hidden" value="EBD4824E-8769-8F6C-0C94-2AFC2BA4EB46">
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</form>Text Content
Get a $750 DoorDash Gift Card Status: Available Now Confirming entry to win Continue below to proceed First Name Last Name E-mail Address 1 Zip Code City State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Date of Birth Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 20062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924 Gender Select Gender Male Female By clicking Continue, I agree to receive marketing and promotional emails from RewardZinga and our partners. I also agree to the Terms & Conditions, including mandatory arbitration, Privacy Policy and site recordation by TrustedForm and Jornaya. Continue Confirming entry to win Thanks! Please confirm your number Phone By clicking the “Continue” button, I provide my affirmative consent to receive marketing phone calls and text messages from Unified Marketing Partner LLC regarding healthcare or promotional products or services on the landline and/or mobile number I provided above even if the phone number provided is on the National Do Not Call registry. Calls may be generated using an autodialer and I can revoke my consent for calls by any reasonable means. I do not need to provide consent to participate in this program or offers promoted on this website and can Click here to continue without providing consent. I also agree to the Terms & Conditions (including mandatory arbitration) and Privacy Policy. Continue EXCITING DEALS JUST FOR YOU! After registering, you will take a short survey and view optional offers curated just for you. You will then have the opportunity to discover sponsored deals across a variety of games, goods and services. Simply complete 10 of these deals within 60 days and the reward is yours! HOW FAST CAN I ACCESS MY REWARD? Most deals can be completed within 7 days from signing up. Many of our partner deals require payments for products and services rendered. Once you complete the required number of deals, we will contact you to complete the Rewards claim process. Be sure to sign up with your correct contact details so we can contact you and verify your identity to provide your reward. * Terms & Conditions | * Unsubscribe | * Privacy Policy | * Program Requirements | * Do No Sell My Info | © RewardZinga, 2024