Region - 2024 Event Request for Refund
This form must be submitted to GNSW with a copy of a Medical Certificate attached. As per the Events Policy, Request for Refund Applications will not be processed if received more than one week after the event. All refunds incur a 15% administration fee, refunds will be paid to the club.
Club Name
*
Club Contact
*
Club Phone
*
Club Email
*
example@example.com
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Name of Event
*
Event Date
*
/
Day
/
Month
Year
Region
*
Choose Gymsport
Central West
Far North Coast
Hunter
Inner City
Met West
North West
Northern
Outer City
Riverina
South Coast
Southern
Withdrawing Athlete's Name
*
First Name
Last Name
Level
*
Partners of Withdrawing Athlete
*For Acro, Aero and RG only
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Reason for Request
*
Medical Certificate
*
Browse Files
Select the Medical Certificate to attach
Cancel
of
Refund Requested By
*
First Name
Last Name
Position in Club
*
Signature
Date Submitted
*
/
Day
/
Month
Year
Date
Submit
Should be Empty: