Believe & Achieve Day: Ultimate 2022
Please complete in the name of the young person attending the event
Date of Birth
Emergency contact details
Emergency contact name
Emergency contact number
Emergency contact relationship to you
Parent/guardian & emergency contact details
Parent/guardian contact name
Parent/guardian contact number
If attendee is under 18 please could parent/guardian tick this box to confirm consent is given
I confirm consent is given to attend event
Have you been to a Believe & Achieve event before?
What was you favourite short activity or game? e.g. Challenge day games, painting, vision boards, egg drop etc
Please include who had it, type of meningitis if known, age at diagnosis and approximate date of illness
Are you willing to share your story with the media and help us to raise awareness about meningitis, the work of Meningitis Now and your involvement?
We want you to have a fantastic time at this event, so we must be fully aware of the needs of those wishing to attend so that we can accommodate for additional support where possible.
Emergency contact: Full name, phone number and their relationship to you
Are you bringing a friend or carer?
Your friend will also need to register for the day
Name of your friend/carer
We wish to support the requests of those hoping to attend so that we can accommodate for additional support where possible
Do you have a disability/medical condition we should be aware of?
Please give details including any additional support needs we should be aware of
Please give details of any needs we should be aware of, including any specific anxieties or accessibility issues
Please give details of any medications you are taking we should be aware of, and how these should be stored on the day
Do you have any dietary requirements?
Dietary requirements or food allergies? (For example, vegetarian, halal, vegan, gluten free etc)
Are you hoping to stay for B&A:Graduation?
Not sure yet
Have you completed the required B&A Graduation registration form?
Have you been in contact with Believe & Achieve before?
How did you hear about Believe & Achieve?
Meningitis Now website
Other - how I heard
I agree to myself and/or my family being filmed or photographed at the above event. Meningitis Now may use any photographs or films taken, in any literature, publicity, information material or publication promoting the work of Meningitis Now. Copyright belongs to Meningitis Now. A copy of our Filming and Photographic policy is available on request.
Yes, I agree
No, I do not agree
Keep in touch
Please let us know what you'd like to hear about
Get informed: Meningitis information
Get support: How we support those affected by meningitis
Get involved: How you can support us
All the above
I don't want to hear from you
Meningitis Information:- includes updates about the impact of the disease, vaccine programmes, our campaigns, and media activity...... How we support those affected:- includes our Family Days, Believe & Achieve weekends, Forever Days, invitations to some key events organised by us e.g. Christmas Carol Concerts...... How you can support us:- includes information about donating your time through volunteering or organising fundraising activities, how to get involved by taking part in an event such as Three Peaks Challenge, or our Five Valleys Walk and how you can donate to us through our cash appeals, or by purchasing merchandise e.g. Christmas cards
And please let us know how we can contact you
We will only communicate with you about the aspect(s) of our work you’ve requested, in the way(s) that you have requested. We may also contact you for administrative purposes or to fulfil a service or request. We never sell our supporter data and only share this with suppliers helping us in our cause. To find out more about how we process personal data and respect your rights, please visit our
Please complete the following before you submit your form
I agree to the Terms and Conditions (link below)
I have read and understood the Meningitis Now Safeguarding Statement (link below)
Terms and Conditions
If you have any queries regarding registration for this event, please email
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.