WGHA Refund Request Form (Whitby Girls Hockey Association)

WGHA Refund Request Form

Please ensure you have read the withdrawal charts and understand the dates in which you are eligible for a refund.

Refund Information

Date of Request^*

Required

First Name of Person Requesting Refund^*

Required

Who cheque should be made payable to

Last Name of Person Requesting Refund^*

Required

Who cheque should be made payable to

Email Address^*

Required

Example: [email protected]. Your submission will be sent to this address.

Primary Contact Phone Number ^*

Required

Example: ###-###-####

Mailing Address^*

Required

City ^*

Required

Postal Code ^*

Required

Team Information

Full Name of Player Withdrawing^*

Required

First and Last Name

Date of Birth^*

Required

Date of Birth of Player Withdrawing

Division^*

Required

Level^*

Required

House League Team Number

If already placed on a HL team, please indicate Team #

Coach^*

Required

Coaches name if already placed on a team. If not, NO COACH.

Reason

Please indicate the reason why the player is withdrawing from the WGHA^*

Required

Note: if the withdrawal is related to illnesses or injuries, a copy of the doctor's note must be provided to the WGHA Registrar at [email protected]

WGHA Refund Request Form (Whitby Girls Hockey Association)

Refund Information

Team Information

Reason

Office Use Only

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