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DANCE4LIFE COIN ICO REGISTRATION FORM
This form is to show you have paid the ICO FEE and are a registered to receive your coins.
You are receiving 10.000 coins for 0.01BTC. You may purchase as many as you wish. 10% of all funds collected are donated to charities in the fight against AIDS. We thank you for your help.
username from bitcoincoin is also valid.
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your transactin id for your purchase
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please forward funds to the following address: *12xDQL2qSJRcejWm2ENQnzfR
2fbHmh8qBs*
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