Program Refund and Transfer Request Form

Withdrawal and Transfer Request Form
Program withdrawal requests must be submitted no later than 7 days prior to the program’s start date.

Activity transfer requests must be submitted prior to both programs’ registration deadlines if space allows.
Any requests received after the deadline (with the exception of long-term medical exceptions with a dated doctor’s note dropped off in person or sent to bkoudelka@wheelingparkdistrict.com) will not be honored. The enrollee will remain enrolled and welcome to attend.

This form is not applicable to punch passes, season passes, memberships, private lessons, facility rentals, summer camp, BASR, or Preschool.

Health & Fitness Center Membership Cancellations must be done in person at the Health Fitness Center.

Please allow up to 5-7 business days for request review to be completed
Date/Time Submitted

MonthDayYear
Date
Hour MinutesAM/PM Option
Participant Name*

First NameLast Name
Requester's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
(For request communications/receipts)
Request Type*

TransferCancellation