Registration Refund (Blyth Brussels Minor Hockey)

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Registration Refunds:
For BBMHA Player refunds there will be 10% deducted from the registration cost per week until Dec 1st (No Refund to be issued after Dec 1st .)

Please note: Fundraising Tickets are not refundable.

Player Information

Last Name (Player)^*
First Name (Player)^*
Year of Birth^*

Requestors Information

Last Name^*
First Name^*
Phone Number^*

Example: ###-###-####
Email Address^*

Example: yo[email protected]. Your submission will be sent to this address.
Mailing Address^*

Payment Information

Payment Method^*
E TransferCheque

Reason for Player Withdrawal

Reason for Refund:^*
Registration Refund - Moving Associations (AAA Waiver)
Registration Refund - Family Relocating
Registration Refund - Medical
Registration Refund - Not Playing Hockey
Other
Comments

Human Validation

Check The Box ^*