WGAC REQUEST FOR PLAYER REFUND
REQUESTOR'S NAME:  
PLAYER'S NAME:  
TEAM (CIRCLE): CHEERLEADING          FOOTBALL
DIVISION (CIRCLE): Flag   Mitey Mite Hawk   Mitey Mite   Jr Pee Wee   Pee Wee   Jr Midget   Midget
REASON FOR REFUND  

DATE OF REQUEST:

  
Make sure a copy of receipt of payment is attached to this form!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
OFFICIAL USE ONLY:  
RECEIPT OF PAYMENT ATTACHED (CIRCLE): YES                         NO
UNIFORM/EQUIPMENT RETURNED: YES                         NO
FUNDRAISING ACTIVITY RETURNED: YES                         NO
APPROVED BY:  
AMOUNT PAID:  
DATE PAID:  
CHECK # :  
TREASURER'S INTIALS:  

 

WGAC
PO Box 25
Camillus, NY 13031