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2. 
4. First Name of Payee (person who paid)*
5. Last Name of Payee (person who paid)*
7. First Name of Registrant *
8. Last Name of Registrant *
10. Address1*
12. City*
13. State*
14. Zip*
16. Course/Class/Trip Name*
17. Day of the week of Class/Trip*
    -- Select One --MondayTuesdayWednesdayThursdayFridaySaturdaySunday
18. Class/Trip start date *
    Class/Trip start date
19. Time of Class/trip:
    Time of Class/trip:
21. The decision to maintain classes is based on the enrollment at the first class; refunds are not guaranteed after the first session/class. Participants assume the risk of changes in personal affairs and health. No refund for materials purchased. Classes that are subcontracted may be non-refundable. Each request will be submitted for approval on a case-by-case basis. If a session/class was attended, the refund may be subject to a prorated amount.
23. Refund requests will be subject to a 5% processing fee, with a minimum of $5 and a maximum of $25 (Exceptions below)
25. EXCEPTIONS: Overnight trip arrangements, requests made after the noted deadline or after tickets/materials are purchased. City Day Camp refunds (see below)
27. City Day Camp Refunds: All City Day Camp refund requests made prior to the last Friday PRIOR to the start date of camp are subject to 50% processing fee of refund amount. NO REFUNDS ISSUED after the final Friday prior to camp start date.
29. Some programs are non-refundable, for a list of non-refundable programs
    click here
31. Were any classes/days attended? *
    -- Select One --Yes, if yes answer next questionNo
32. If yes, how many?
34. Participants will be refunded in the same manner in which they paid.
36. Please state reason(s) you are requesting a refund, including if reimbursement is due to a medical situation.*
38. Signature (typed name serves as an electronic signature)*
39. Date*
    Date
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41. 1. Receive an email copy of this form.
42. Email address

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