Membership sign-up
You should use this form if you (as an under-19) or your child (as the parent of an under-19) would like to attend Prewired sessions.

There are no costs or benefits associated with membership, nor obligation to attend sessions. This is just to make everyone’s lives a little bit easier. If you would rather we didn’t hold this information, let us know and we will remove your information from our database. Our privacy policy is available on our website: https://www.prewired.org/privacy/
Sign in to Google to save your progress. Learn more
Attendee details
Full name *
Email address
Any allergies or specific dietary requirements? *
Any medication it would be useful for us to know about? *
Any illnesses, injuries or conditions that it would be useful for us to know about? *
A website, blog, or cool project they'd like us to know about?
Emergency contact details
Emergency contact name *
Emergency contact relationship to attendee *
Emergency contact phone number *
Emergency contact email address *
The attendee may be photographed or filmed during Prewired events and these photographs may be used in print or online publicity for future Prewired events. *
You give us permission to store these details, printed or electronically for as long as we deem necessary for the successful running of Prewired. However, we’ll log attendance and will automatically delete them if we don’t see you at Prewired for 6 consecutive weeks. *
Required
You also agree to make sure these details are up to date. If anything changes, please let us know by email (hello@prewired.org)! We’ll send you a reminder every six months or so. *
Required
This form is being filled out by... *
(Choose all that apply)
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Prewired.