Llwybr tân y Ddraig Goch / The Red Dragon Firewalk - sign up

Fire Walk 2025

Personal details

Title

First Name

Last Name

Date of Birth

DD/MM/YYYY

Phone

Whichever is your preferred number

Street Address

Town or City

Postcode

County

Country

Meningitis experience

Your meningitis experience

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?

If yes and are happy to give some brief details, please write below

Ticket & Free T-Shirt

Payment details

Single registration £25Plus you also pledge to endeavour to raise at least £150 in sponsorship

T-shirt size

Name on T-shirt

Emergency contact details

Emergency contact name

Emergency contact number

Emergency contact relationship to you

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:

yes pleaseno thanks

Phone

yes pleaseno 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 and conditions

By submitting you agree to the below Terms and Conditions

I agree

Terms and Conditions

Payment

Click 'submit' to be redirected to the payment page, and please have your credit or debit card ready or you can use Apple Pay or Google Pay. Please note we don't accept AMEX.

Contact Information