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2a02:26f0:ab00::b819:326a  Public Scan

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Submitted URL: https://s.viisemblin.com/h/893/m34usqpluv7fvbg4t2ci3lgjwktukt4x2s5kynksx3zinnxez76g46g2jbiwovkcbbuqaqjdr6tmv7kch4zos5e7gt...
Effective URL: https://register.bet9ja.com/?btag=a_326b_4c_4025677083&s1=2230-9ab2598eabed8e43&promocode=&clickid=cnvc162db948c15fc28783696...
Submission: On July 02 via api from US — Scanned from NL

Form analysis 1 forms found in the DOM

<form class="registration-form">
  <div class="registration-form__row  "><label class="registration-form__label" for="email">Email</label><input id="email" class="registration-form__input" type="text" value="">
    <p class="registration-form__error"><span class="registration-form__error-i pull-left mr5"></span></p>
    <p class="registration-form__info-bg">A valid email is required to register and withdraw funds.</p><i class="registration-form__status icon-input-success"></i><i class="registration-form__status icon-input-error"></i>
  </div>
  <div class="registration-form__row  "><label class="registration-form__label" for="first-name">First Name</label><input id="first-name" class="registration-form__input" type="text" value="">
    <p class="registration-form__error"><span class="registration-form__error-i pull-left mr5"></span></p>
    <p class="registration-form__info-bg">Enter your First Name as it appears in your bank account.</p><i class="registration-form__status icon-input-success"></i><i class="registration-form__status icon-input-error"></i>
  </div>
  <div class="registration-form__row  "><label class="registration-form__label" for="last-name">Surname</label><input id="last-name" class="registration-form__input" type="text" value="">
    <p class="registration-form__error"><span class="registration-form__error-i pull-left mr5"></span></p>
    <p class="registration-form__info-bg">Enter your Surname as it appears in your bank account.</p><i class="registration-form__status icon-input-success"></i><i class="registration-form__status icon-input-error"></i>
  </div>
  <div class="registration-form__row  "><label class="registration-form__label" for="day">Date of birth</label>
    <div class="d-f registration-form__row-dob">
      <div class="registration-form__input-wrapper"><input id="day" class="registration-form__input " type="number" placeholder="DD" value=""></div>
      <div class="registration-form__input-wrapper"><input id="month" class="registration-form__input " type="number" placeholder="MM" value=""></div>
      <div class="registration-form__input-wrapper"><input id="year" class="registration-form__input " type="number" placeholder="YYYY" value=""></div>
    </div>
    <p class="registration-form__error"><span class="registration-form__error-i pull-left mr5"></span></p><i class="registration-form__status icon-input-success"></i><i class="registration-form__status icon-input-error"></i>
  </div>
  <div class="registration-form__row   registration-form__row--success"><label class="registration-form__label" for="promo-code">Promotion Code (optional)</label><input id="promo-code" class="registration-form__input" type="text" value="326"
      disabled="">
    <p class="registration-form__error"><span class="registration-form__error-i pull-left mr5"></span></p><i class="registration-form__status icon-input-error"></i>
  </div><button type="button" title="Continue" disabled="" class="btn-primary-s registration-form__submit ">Continue</button>
</form>

Text Content

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Step 1
Step 2
Step 3
Email



A valid email is required to register and withdraw funds.

First Name



Enter your First Name as it appears in your bank account.

Surname



Enter your Surname as it appears in your bank account.

Date of birth




Promotion Code (optional)



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