Tree of Life registration
Welcome to registration for the Tree of Life in Leicester on Thursday 23rd July. The event will start at 10:30am and ends at 3:30pm. If you have any questions, or are unable to complete this form please give Adam a call on 07584886533 or email him at adam.mayze@diabetes.org.uk and he will be able to help you complete the form.
1. First Name
*
2. Last Name
*
3. Email Address
*
4. Phone number
*
5. Address line 1
*
6. Address line 2
7. City
*
8. County
9. Postcode
*
10. Are you a
*
Person living with diabetes over the age of 16 who would like to attend the event themselves
Parent or carer of a young person living with diabetes who you'd like to attend event
