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The CML Life Africa Leadership Summit - hosted by The Max Foundation

17-19 August 2018

Entebbe, Uganda

 

Please enter your information below to register for the conference.

Full Legal Name *
Full Legal Name
Please enter First and Middle names in the "First Name" box and Surname in "Last Name" box.
Date of Birth *
Date of Birth
Address *
Address
Emergency Contact Address
Emergency Contact Address
Primary Physician Office Address
Primary Physician Office Address