Refund Request Form

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Player Information:

Player Full Name

Please indicate the South Four Program registered for:

U3-U4 Early Dribblers

U5-U6 Active Start

U7-U8 FUNdamentals

U10-U11 Learn to Train

U7-U19 CMSA Programs

Technical Training

Parent/Guardian First Name:

Parent/Guardian Last Name

Contact Number

Email

Please indicate the reason you are requestig a refund:

CREDIT PowerUp Account (unused portion will go back onto players PowerUP ccount)

Player requesting release to another Soccer Club in Calgary.

Player no longer wishes to play soccer.

Medical Reason or Injury (Dr's Note required).

No Team for placement.

Other

Date

Initials

I confirm that the information given in this form is true

Thanks for submitting!

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