milliondollarvax.com
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URL:
https://milliondollarvax.com/
Submission: On October 11 via manual from AU — Scanned from DE
Submission: On October 11 via manual from AU — Scanned from DE
Form analysis 1 forms found in the DOM
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<div class="card-input"><input name="firstName" class="card-input__text" type="text"> <label class="card-input__label">First Name*</label>
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<div class="card-input"><input name="confirmEmail" class="card-input__text" type="text"><label class="card-input__label">Confirm Email Address*</label>
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<div class="card-input"><select name="state" class="card-input__text">
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<option value="Australian Capital Territory">Australian Capital Territory</option>
<option value="New South Wales">New South Wales</option>
<option value="Northern Territory">Northern Territory</option>
<option value="Western Australia">Western Australia</option>
<option value="Queensland">Queensland</option>
<option value="South Australia">South Australia</option>
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<option value="Victoria">Victoria</option>
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<div class="grid-container"><input type="checkbox" name="acceptAr"> <label>I am 18 years of age or older and I have read and accept the
<a href="https://milliondollarvax.com/vaxterms.pdf" target="_blank" rel="noreferrer" style="text-decoration: underline; color: rgb(0, 0, 0);">Competition Terms </a></label></div>
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<div class="chk">
<div class="grid-container"><input type="checkbox" name="acceptPp"> <label>I acknowledge that as a condition of entering I have received a first vaccination in accordance with the National COVID-19 Vaccination Program and understand that in order
to be eligible to win a prize, I must be fully vaccinated and provide the proof required by the Promoter (including, without limitation, my COVID-19 vaccination certificate or immunisation history statement and acceptable photo
identification) prior to the 13th December 2021</label></div>
<p class="error-message"></p>
<div class="grid-container"><input type="checkbox" name="acceptTc"> <label>I acknowledge and accept that any decision to receive a COVID-19 Vaccination must be undertaken on the advice of a health practitioner and, by entering the Million Dollar
Vax Trade Promotion Lottery, I warrant to the promoter that I will or have received (as the case may be) such advice prior to receiving a COVID-19 Vaccination during or following the Promotional Period</label></div>
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<p><small>* mandatory field</small></p>
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<p class="error-message"></p><button type="submit" style="margin-top: 10px;"> Submit</button>
<p style="margin-top: 15px;"><small>This initiative has been created by the Million Dollar Vax Alliance, a group of generous philanthropists and corporations to accelerate Australia's COVID-19 vaccination program. in a safe and secure way. The
faster we reach higher vaccination rates nationally, the sooner we all can safely resume our full range of community and business activity</small></p>
</form>Text Content
You need to enable JavaScript to run this app. Million Dollar Vax Promotion Entry Please complete the form below for your chance to win one of 3,100 Ultimate eGift Cards valued at $1000,being given away each day in the month of October and be entered into the Major Prize of $1,000,000 cash,drawn on November 5! The Million Dollar Vax promotion is open to all Australian residents 18yrs or older Want to know more? Please refer to the FAQ's and Terms & Conditions First Name* Last Name* Email Address* Confirm Email Address* Date of Birth* Mobile Phone Number* Postcode* Suburb* Select...Australian Capital TerritoryNew South WalesNorthern TerritoryWestern AustraliaQueenslandSouth AustraliaTasmaniaVictoriaState* I am 18 years of age or older and I have read and accept the Competition Terms I acknowledge that as a condition of entering I have received a first vaccination in accordance with the National COVID-19 Vaccination Program and understand that in order to be eligible to win a prize, I must be fully vaccinated and provide the proof required by the Promoter (including, without limitation, my COVID-19 vaccination certificate or immunisation history statement and acceptable photo identification) prior to the 13th December 2021 I acknowledge and accept that any decision to receive a COVID-19 Vaccination must be undertaken on the advice of a health practitioner and, by entering the Million Dollar Vax Trade Promotion Lottery, I warrant to the promoter that I will or have received (as the case may be) such advice prior to receiving a COVID-19 Vaccination during or following the Promotional Period * mandatory field Submit This initiative has been created by the Million Dollar Vax Alliance, a group of generous philanthropists and corporations to accelerate Australia's COVID-19 vaccination program. in a safe and secure way. The faster we reach higher vaccination rates nationally, the sooner we all can safely resume our full range of community and business activity FAQs & Support Terms And Conditions Winners Instagram Youtube facebook