APMHA Refund Request Form (Ajax Pickering Minor Hockey)

Print 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:^*
Parent/Guardian Last Name:^*
Parent/Guardian Email Address:^*

Example: [email protected]
Parent/Guardian Mailing Address:^*

Please indicate full mailing address including City and Postal Code.
Parent/Guardian Phone Number:^*

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

Player Information

Player First Name:^*
Player Last Name:^*

Player Date of Birth:^*

Open the calendar popup.

Division:^*

Example: U11 or Hockey School
Current Team:^*

Example: U11 Blue or U10AA
Reason for Refund Request:^*

Human Validation

Check The Box ^*

APMHA Refund Request Form (Ajax Pickering Minor Hockey)

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