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Families Facing Diabetes Annual Conference
Event Timing: May 6, 2022 8 am to 4 pm
Event Address: Chateau Louis Hotel 11727 Kingsway NW, Edmonton, AB
Event Fee: $20 per person pre registration $25 per person at the door
Contact us at info@kidsnus.ca
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Email
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First Name
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Your answer
Last Name
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Your answer
Mailing Address Including City and Postal Code
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Your answer
Phone Number
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Your answer
How many people are attending? (Kids and Adults)
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Your answer
Please list the names of all who are attending. For those 18 and under please include age and gender.
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Your answer
Who has type 1 diabetes?
Your answer
If you are using a pump, which do you use?
Your answer
If you are using a continuous glucose monitor, which do you use?
Your answer
Please check any dietary restrictions applicable to any of the individuals attending.
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None
Vegetarian
Vegan
Kosher
Gluten-free
I understand I need to pay my conference fees and will pay by
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E Transfer to
info@kidsnus.ca
(preferred)
Mailing a cheque payable to Kids n Us to Kids n Us c/o Baumgartner & Company 12816 St. Albert Trail NW, Edmonton, AB T5L 4H6
Pay at event
I have read the Children's Activity Information and give permission for the child(ren) listed to participate in all activities. I understand that this is a public event and publicity photos may be taken and posted on the kidsnus.ca website. The Kids 'n' Us: Families Facing Diabetes Society, volunteers, and event sponsors are not responsible for any loss, theft, or injury to event participants.
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