Schomberg Minor Hockey Association

 

Schomberg Minor Hockey Association

REQUEST FOR REFUND

 

Please complete the following form and mail to:

Schomberg Minor Hockey Association

P.O. Box 145

Schomberg, Ontario

L0G 1T0

Att: Treasurer

 

I wish to request a refund for:

 

(please print player name)

who stopped playing in the Schomberg Minor Hockey Association on:

Date: ______________________________ Age Level: ____________________________

Team: ___________________________________________________________________

This may be verified by contacting the following Official associated with the team: Official: _________________________________              Position: _______________________

Phone: ___________________________________

Reason for leaving the S.M.H.A

__________________________________________________________________________________________________________________________________________________

Please send the refund cheque to:

Name: ___________________________________________________________________

Address: _________________________________________________________________

Date: __________________________________              Phone: _________________________

Signed: ________________________________

 

S.M.H.A. use only:

Registration Received: $___________________                      Refund Issued: $_________________

Cheque: Number: _________________________                 Date Approved: __________________

Signed: _________________________________

 

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Last Updated June 25, 2010 by Bruce Leonard