Registration Cancellation Form

Participant / Student Last Name*
Participant / Student First Name*
Email Address*
Program*
Please select the program you are registered for. If other, enter the program below.
If you selected other, Please specify.
Reason for Cancellation*
If you selected other, Please specify.
Parent's Name

Parent’s Full Name for Child Registrant
Cancellation Date*
MM slash DD slash YYYY

Cancellation requests must be submitted by the last day of current cycle (month) to terminate recurring payment/membership for the following billing cycle (month).
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Policy for recurring payments

All payments are non-refundable. All payments are billed automatically on the first day of your billing cycle for the entire month. There are no pro-rated refunds for mid-month cancellations. Cancellation requests must be submitted by the last day of current cycle (month) to terminate recurring payment/membership for the following billing cycle (month).

Cancellation request in person

Request can be made at the Front Desk of Burgess Pool.