Swim Lessons Refund Request Form

Name

Participant Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Class

Start Date

Class Time

Amount Paid

# of classes missed*

* Credit is not given for missed classes.
If the Y cancels class, credit will be issued.

Instructor

I have read the Credit/Refund Policy below and understand it, and feel a credit/refund is due because:

Credit/Refund Policies

Receipt must be attached in order to process.
Allow up to 2 weeks to process
Credit must be used within in 1 year
Credit/refund is not given for missed classes
If the Y cancels class refund/credit will be issued
Request for credit needs to be made 72 hours prior to start of program or the first class meeting.
Refer to separate Camp/Childcare policies for credits/refunds.

All credits are subject to a $5 processing fee.
Refunds are subject to the following Processing Fees:
Under $10: No refunds given
Up to $20: $5 processing fee
Up to $30: $7 processing fee
Over $30: $10 processing fee

Certain programs do not qualify for Credit/Refunds (Membership Join Fees, Program deposits etc.)

I agree to the above credit/refund policies.

Credit/Refund Policies

*Certain programs do not qualify for Credit/Refunds (Membership Join Fees, Program deposits etc.)*

Certain programs do not qualify for Credit/Refunds (Membership Join Fees, Program deposits etc.)