APMHA Refund Request Form (Ajax Pickering Minor Hockey)

APMHA Refund Request Form

Please complete the online refund request form to request a refund for/withdrawal from APMHA programs. All refund requests must be submitted using this form and are subject to approval by the APMHA. The request must include all required information indicated on the form. All refunds provided are in conjunction with the APMHA refund policy (including no monetary refunds after a specific date indicated in the refund policy). Please allow 4-6 weeks to process your request.

Parent/Guardian Information

Parent/Guardian First Name:^*

Required

Parent/Guardian Last Name:^*

Required

Parent/Guardian Email Address:^*

Required

Example: [email protected]

Parent/Guardian Mailing Address:^*

Required

Please indicate full mailing address including City and Postal Code.

Parent/Guardian Phone Number:^*

Required

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

Player Information

Player First Name:^*

Required

Player Last Name:^*

Required

Player Date of Birth:^*

Required

Division:^*

Required

Example: U11 or Hockey School

Current Team:^*

Required

Example: U11 Blue or U10AA

Reason for Refund Request:^*

Required

APMHA Refund Request Form (Ajax Pickering Minor Hockey)

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Parent/Guardian Information

Player Information

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