<form method="post" action="https://rebels.extinctionrebellion.be/public/rebels">
<input type="text" name="rebel[name]" id="rebel_name">
<input type="email" name="rebel[email]" id="rebel_email" required>
<input type="tel" name="rebel[phone]" id="rebel_phone">
<input type="text" name="rebel[postcode]" id="rebel_postcode">
<input type="hidden" name="rebel[local_group_id]" id="rebel_local_group_id" value="[YOUR_LOCAL_GROUP_ID]">
<!-- for notes/skills -->
<textarea name="rebel[notes]" id="rebel_notes"></textarea>
<input type="checkbox" name="rebel[consent]" id="rebel_consent">
<!-- value can be: en, fr, nl -->
<input type="hidden" name="rebel[language]" id="rebel_language" value="en">
<!-- rebel will be redirected to the global 'Thank You' page -->
<!-- but you can provide another URL -->
<input type="hidden" name="rebel[redirect]" id="rebel_redirect" value="https://xr-city.be/welcome">
<input type="submit" value="Join the Rebellion">