CPGHA Refund Form (Carleton Place Minor Hockey Association)

CPGHA Refund Form

IMPORTANT: Hockey Canada and HEO fees are embedded in all CPMHA registration fees. These fees, which may vary from year to year, are non-refundable. If a refund request is made, it will be processed according to the CPMHA refund policy, less the current Hockey Canada and HEO fees. Players who are expelled or suspended are not entitled to a refund.

Refund Policy

Up to December 31st, if you withdraw your child from CPMHA, you will receive a partial refund based on the following schedule, less the mandatory insurance fee:

Withdrawal Prior to September 15th: 100% refund
Withdrawal Between November 1st and November 30th: 90% refund (10% reduction)
Withdrawal Between December 1st and December 31st: 80% refund (20% reduction)

No refunds will be issued after December 31st.

When you submit this form, a copy will be sent to the Registrar and Treasurer to be considered.

PLAYER INFORMATION

Player's Name^*

Required

First and Last

Parent's Name^*

Required

First and Last

Team Name^*

Required

Reason For Withdrawl^*

Required

Mailing Address^*

Required

ex. 75 Neelin St, Carleton Place, ON, K7C 4H1

Phone Number^*

Required

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

Email Address^*

Required

Example: [email protected]

Coach’s Information

Applications will not be processed without this information.

Coach's Name^*

Required

First and Last

CPMHA will contact the coach to verify all equipment (ex. jersey/goalie equipment) is returned prior to processing any refund.

I acknowledge that I have returned all of my equipment

I understand that submitting this form acts as my electronic signature, just as if I had signed it by hand.

This selection is mandatory^*

CPGHA Refund Form (Carleton Place Minor Hockey Association)

PLAYER INFORMATION

Coach’s Information

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