Refund Request Form 2023-2024
SAMHA
Name of Participant
First Name
Last Name
Stream of Play:
Raiders
SAMHA
Rec
Division:
Please Select
U7
U9
U11
U13
U15
U18
Name of Guardian
First Name
Last Name
Birthdate of Participant
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Please indicate the reason for your refund request:
Player requesting release to another Hockey Alberta Association
Player intending to play in a non-sanctioned hockey league
Player does not want to play hockey anymore
Medical reason or injury
Other
Other reasons or comments:
Submit
Should be Empty: