COSTA RICA Payment Recall

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ALL parents/ students who signed up for this trip need to fill out this form to let us know how to proceed with deposits that were made for the band trip. Please fill this out for each person signed up for the trip.

Email *

Name (Last, First) *

Payment TYPE *

CASH

CHECK

CHARMS

I would like you to... *

Keep my deposit and apply to the new trip (you will need to fill out new trip paperwork at that time, no one will automatically be signed up for the new trip/ destination). If I choose to not attend that trip, I understand that I can request that refund at a later date.

Keep my deposit and apply to any outstanding/ future band fees.

Refund my deposit back to me.

IF Refund is requested, please submit name that refund will go to below. Also please make sure that you are using the same e-mail to fill this form out as the original e-mail used to sign up for the trip.

Student ID Number

Chaperones, please provide what you'd like your Chaperone ID to be, you will use this in accessing CHARMS trip payments (letters and numbers, 8 characters)

Please submit this information for verification

Address

City, State, Zip

Untitled Title

Submit

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