AYSO Region 1678 - Registration Refund Request

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Please fill out this form to request a refund for the Fall Season. This form must be submitted in order to receive any refund listed below. Please allow 3-6 weeks for us to process your request.

Questions? Contact the Region 1678 Treasurer at treasurer@ayso1678.org or the Regional Commissioner at RC@ayso1678.org

Refund Dates and Amounts

Below are the posted dates and amounts for refunds in Region 1678. Please acknowledge below that you understand.

I have read and understand the AYSO Region 1678 Registration Refund Policy.

Name of Player (First and Last Name) *

Player's Date of Birth *

YYYY

Player's Division (Boys or Girls) and Age Group (5U-19U)

(Example: Boys 10U)

Your name (First and Last) *

Your address (refunds are given via Region check) *

Your Phone number (in case we have any questions) *

Your email address *

Reason for withdrawal/refund *

Submit

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