DAFNE Collaborative Meeting

DAFNE collaborative meeting

Tuesday28th June 2016

Barnes Wallis Building, The University of Manchester, Sackville Street Campus,Manchester M1 7JR

Registration form

To register for the DAFNE collaborative meeting 2016 complete the form below. Please note a cancellation fee will be charged for non-attendance (see cancellation process below).

The following delegates from (centre name)

would like to register attendance at the DAFNE collaborative meeting onTuesday28thJune 2016.

Delegate 1

Name: / Position: / £Free

Contact address:Dietary requirements:

Email:
Workshops
(Places will be allocated on first come basis) / Preference
(1-3)
1 / Supporting patients using CGM during DAFNE
2 / Management of advanced physical activity using the DAFNE regime
3 / Supporting adults newly diagnosed with type 1 diabetes

Delegate 2

Name: / Position: / £Free

Contact address:Dietary requirements:

For additional delegate registration please complete page 2. Additional delegate places will be allocated week commencing 2thMay 2016.

Cancellation information for delegates

The DAFNE collaborative reserves the right to levy a cancellation fee in the event of withdrawal from the event once we have confirmed booking by the person or body making the booking. Therefore please contact central DAFNE immediately at to advise if you are unable to attend. Cancellation fees are:

Cancellations received up to 27 May 2016 will be charged at £42.50.
Cancellations received after 27 May to day of event will be £47.50 which includes the delegate pack
Non-attendance on the day will be charged at £47.50 which includes the delegate pack

Number of additional delegates:

Delegate 3

Name: / Position: / £Free

Contact address:Dietary requirements:

Delegate 4

Name: / Position: / £Free

Contact address:Dietary requirements:

Collaborative meeting sponsored by: Silver – Abbott Diabetes Care and Lilly Diabetes