Regional Connect Event - Cardiff 2026
Page 1
This event is for 18 plus and is limited to 2 spaces per registration
Main Participant
Title
Please select...
Mr
Mrs
Ms
Miss
Mx
First Name
Last Name
Date of Birth
Enter date as dd/mm/yyyy
Mobile number
Email
Street address
Town
Postcode
Do you have any accessibility needs that those running the event need to be aware of?
Yes
No
If yes, please provide details of your accessibility needs
Do you have any dietary requirements? (For example, allergy, intolerance, vegetarian, halal, vegan, gluten free etc
)
Yes
No
Please state your dietary requirements
Are you are registering another person to attend the Regional Connect Event in Cardiff
Yes
No
Second Participant
Title
Please select...
Mr
Mrs
Ms
Miss
Mx
First Name
Last Name
Date of Birth
Enter date as dd/mm/yyyy
Mobile number
Email
Street address
Town
Postcode
Do you have any accessibility needs that those running the event need to be aware of?
Yes
No
If yes, please provide details of your accessibility needs
Do you have any dietary requirements? (For example, allergy, intolerance, vegetarian, halal, vegan, gluten free etc
)
Yes
No
Please state your dietary requirements
Page 2
Meningitis details
Who has had meningitis?
Please select...
Myself
Son
Daughter
Wife
Husband
Mother
Father
Relative
Other
Please share your meningitis experience below
Emergency contact details
Emergency contact name
Emergency contact number
Emergency contact relationship to you
Event Contact preferences
Please tell us your preferred method(s) of communication in relation to this event (please tick all those that apply) we will try to communicate with you in this way where possible
Email
Phone
Text
WhatsApp
Post
Any
Permissions
It is important that we understand the impact and value of attending a Meningitis Now support event has had on you and your family, so that we can share this with our funders and continue to secure potential funding for our programme of family support events in the future. Please indicate if you would be willing to share your experience, e.g. case study, evaluations in our publications, website and on social media.
Yes
No
Photo Consent
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
We’d love to stay in touch and share our news on how we are working tirelessly to save lives and rebuild futures through the work we do. Please tell us how you’d like to hear from us:
Email
yes please
no thanks
SMS
yes please
no thanks
We will send you occasional postal information based on our legitimate interest to communicate with you. You can change your preferences at any time by contacting us at
supporters@meningitisnow.org
or by
updating your preferences
online. Your details will be kept safe - check out our
privacy policy
for more details.
Terms & Conditions
Please complete the following before you submit your form
I agree to the Terms and Conditions (link below)
Terms and Conditions
If you have any queries regarding registration for this event, please email
esmel
@meningitisnow.org
Contact Information