WV COWBOYS Registration Refund Request Form

WV COWBOYS Registration Refund Request Form Participant’s Name: Division: Type of refund requested, please check one:  Full refund, minus $50 administration fee (only available to a participant who drops before the first day of practice)  Partial refund, minus $50 administration fee, (only available prior to certification) Return Check Payable to: Mailing Address: Signature of Requestor: Date Request Submitted to Treasurer: Head AD Signature: Head Coach/Coordinator Signature: NOTES:  Refunds of any kind are not available to a participant who does not meet the Academic requirements of a 2.0 GPA  Refunds of any kind are not available to a participant who has been certified.  Amount of partial refunds are determined on a case by case basis.  Allow 2-3 weeks for processing.

Email completed form to City Treasurer at: [email protected]

Treasurer Use Only: Check Number: Date Processed: Signature: Notes: