Refund Request Form
Refund requests may only be made prior to the closing date or deadline for all regional events. There are no refunds after the closing date unless specifically stated in the paperwork for the individual event. All refunds will be mailed minus a $5 processing fee.
Today's Date
*
-
Month
-
Day
Year
Date
Pony Club Member Name
*
First Name
Last Name
E-mail
*
Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Pony Club/Riding Center
*
Please Select
Fox River Valley
Brier Bank
Heart of Illinois
Prairie Jumpers
Quad Cities
Royal Oaks
Sangamon Valley
Silver Bits
St. James
Timber Ridge
Wayne DuPage Hunt
Generations Equestrian Center
Other
Activity refund requested for
*
Date of payment
*
-
Month
-
Day
Year
Date
Upload a copy of your receipt showing payment
Browse Files
Cancel
of
Name on PayPal payment
*
First Name
Last Name
Email used for PayPal payment
*
example@example.com
Amount requesting for refund
*
Explanation for refund request
Include whether requesting full or partial refund
For rally refunds after closing date, upload Veterinarian or Doctor's letter
Browse Files
Cancel
of
Submit Form
Should be Empty: