Activity Modification Form, Cancel/Transfer

Activity Modification Form — Cancel/Transfer

Refunds will be applied to any outstanding household balances owed by you for programs, activities, or rentals. If there is no outstanding balance, the refund will be made by check or credit card based upon the method of payment used at the time of registration.
Cash payments will be refunded by check.
Please review the Cancellation and Refund Policy for further details.
Allow up to 2 weeks to receive refund.

Date *

Activity Name or Activity # *

Registrant's Name *

Home Address *

City, State *

ZIP code *

Phone Number

E-mail Address *

Withdrawal Reason (check only one)

Transfer From

Transfer To

Other

Please check here if you would like the refund to remain as a credit on your account.

Checking this box and providing your printed name and date below serves as a digital signature. *

Name *

Date *

CLICK THE SUBMIT BUTTON BELOW TO COMPLETE YOUR REQUEST.