Registration Fee Refund Request
Date of Birth
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Club Name
*
What type of refund are you looking for?
*
Full Refund
HA Levy Refund
Summer/Indoor Partial Refund
State Levy Refund
Association Levy Refund
Club Fees Refund
Other
If other, please outline which levy, or levies, you are looking to get refunded:
Reason for Refund Request (Please include supporting docu like bank statements etc.):
*
Enter the message as it's shown
*
Submit
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