Disbursement Request
Complete this form to request funds from your athlete's Crowns' account be transferred to Reign Elite Cheer. Complete one form per athlete (i.e. if you have two kids then you will need to complete two forms). This form will need to be completed by the 15th of each month to have funds applied for the following month (i.e. form filled out by September 15th will have funds applied to Reign Elite Cheer in October). We will contact you if there are any issues with your request or once the transfer has been completed. Please contact us at: (661) 376-0034 or reignelitecrowns@gmail.com if you have any questions.
Parent/Guardian Full Name
*
First Name
Last Name
Athlete's Full Name
*
First Name
Last Name
Funds Disbursement Amount (specify actual dollar amount you would like transferred to Reign Elite Cheer)
*
Purpose for Request (What do you want funds applied to? Reminder, if you are past due, Reign Elite Cheer may apply the amount transferred to another fee which may not be what you indicated. We notate what the payment is to go towards when disbursing the funds; however, once we disburse your funds we have no control over how it is applied to your Reign Elite Cheer account).
*
Comp Fees
Uniform Fees
Other
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred contact method (We will contact you by your selected method if there are any issues with your request or once the transfer has been completed.)
*
Email
Text
Other
Questions/Comments
Signature
*
Continue
Continue
Should be Empty: