www.beringbou.com.consorcioack.com Open in urlscan Pro
162.215.171.72  Public Scan

URL: https://www.beringbou.com.consorcioack.com/
Submission: On August 23 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

POST registro.php

<form method="post" action="registro.php">
  <div class="form-group">
    <label for="id_evento" style="color: white; font-weight: 600;">Evento</label>
    <select id="id_evento" name="evento" class="form-control">
      <option value="SAB 24.AGOSTO | ZION &amp; LENNOX" selected="">SAB 24.AGOSTO | ZION &amp; LENNOX</option>
    </select>
  </div>
  <div class="form-group">
    <label for="id_evento" style="color: white; font-weight: 600;">Promotor</label>
    <select id="id_promotor" name="promotor" class="form-control">
      <option value="Promotor1">Promotor 1</option>
      <option value="Promotor2">Promotor 2</option>
      <option value="Promotor3">Promotor 3</option>
    </select>
  </div>
  <div class="form-row">
    <div class="form-group col-md-6">
      <label for="dni" style="color: white; font-weight: 600;">DNI</label>
      <input type="text" class="form-control" id="dni" onpaste="res(this);" onkeypress="res(this);" onkeyup="res(this);" name="dni" minlength="8" required="" placeholder="Ingrese su DNI" maxlength="9" �="">
    </div>
    <div class="form-row">
      <div class="form-group col-md-6">
        <label for="nombres" style="color: white; font-weight: 600;">Nombre</label>
        <input type="text" class="form-control" id="name" name="nombre" onpaste="restrict(this);" onkeypress="restrict(this);" onkeyup="restrict(this);" maxlength="20" minlength="11" required="" placeholder="Nombre completo">
      </div>
      <div class="form-group col-md-6">
        <label for="dni" style="color: white; font-weight: 600;">Fecha Nacimiento</label>
        <input type="date" class="form-control" id="datepicker" max="2009-01-01" name="fecha" required="" placeholder="Click en el calendario">
        <br>
      </div>
    </div>
    <div class="form-group col-md-6">
      <label for="telefono" style="color: white; font-weight: 600;">Celular</label>
      <input type="text" class="form-control" id="numero" onpaste="res(this);" onkeypress="res(this);" onkeyup="res(this);" name="numero" required="" placeholder="Whatsapp" maxlength="9" minlength="9">
    </div>
  </div>
  <!-- <div class="form-group">
                            <label for="email">Email</label>
                            <input type="email" class="form-control" id="email" name="email" placeholder="Ingrese su correo">
                          </div>
                          
                          <div class="form-row">
                              <div class="form-group col-md-6">
                                <label for="sexo">Distrito</label>
                                <select id="id_distrito" name="id_distrito" class="form-control">
                                  <option value="0" selected>Elija...</option>
                                  <option value="84">LIMA</option><option value="85">ANCON</option><option value="86">ATE</option><option value="87">BARRANCO</option><option value="88">BRE脩A</option><option value="89">CARABAYLLO</option><option value="90">CHACLACAYO</option><option value="91">CHORRILLOS</option><option value="92">CIENEGUILLA</option><option value="93">COMAS</option><option value="94">EL AGUSTINO</option><option value="95">INDEPENDENCIA</option><option value="96">JESUS MARIA</option><option value="97">LA MOLINA</option><option value="98">LA VICTORIA</option><option value="99">LINCE</option><option value="100">LOS OLIVOS</option><option value="101">LURIGANCHO</option><option value="102">LURIN</option><option value="103">MAGDALENA DEL MAR</option><option value="104">MAGDALENA VIEJA</option><option value="105">MIRAFLORES</option><option value="106">PACHACAMAC</option><option value="107">PUCUSANA</option><option value="108">PUENTE PIEDRA</option><option value="109">PUNTA HERMOSA</option><option value="110">PUNTA NEGRA</option><option value="111">RIMAC</option><option value="112">SAN BARTOLO</option><option value="113">SAN BORJA</option><option value="114">SAN ISIDRO</option><option value="115">SAN JUAN DE LURIGANCHO</option><option value="116">SAN JUAN DE MIRAFLORES</option><option value="117">SAN LUIS</option><option value="118">SAN MARTIN DE PORRES</option><option value="119">SAN MIGUEL</option><option value="120">SANTA ANITA</option><option value="121">SANTA MARIA DEL MAR</option><option value="122">SANTA ROSA</option><option value="123">SANTIAGO DE SURCO</option><option value="124">SURQUILLO</option><option value="125">VILLA EL SALVADOR</option><option value="126">VILLA MARIA DEL TRIUNFO</option><option value="347">PUEBLO LIBRE</option> 
                              </select>
                              </div> 
                              
                              <div class="form-group col-md-6">
                                <label for="sexo">Sexo</label>
                                <select id="sexo" name="sexo" class="form-control">
                                  <option value="0" selected>Elija...</option>
                                  <option value="M">Masculino</option>
                                  <option value="F">Femenino</option>
                              </select>
                              </div> -->
</form>

Text Content

Evento SAB 24.AGOSTO | ZION & LENNOX
Promotor Promotor 1 Promotor 2 Promotor 3
DNI
Nombre
Fecha Nacimiento

Celular

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