AQUATECH SWIM - WITHDRAWAL FORM
PLEASE DO NOT LIST MULTIPLE STUDENTS ON THIS FORM - ONE FORM PER STUDENT. 

To withdraw from ongoing lessons and the 4-week billing cycle, the withdrawal form must be received no later than 8:00 am PST on the final day of the current 4-week billing cycle. Billing reminders are sent 1 week prior to billing dates via email and text message to all enrolled customers. There are no reimbursements or financial credits given for lessons already billed in the current 4-week billing cycle.
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Email *
Which CAMPUS do you wish to withdraw from?  *
Required
REASON for withdrawal notice?  *
Student FIRST & LAST NAME:  *
Student LEVEL:  *
Lesson DAY you wish to withdraw from:  *
Required
TIME of lesson you wish to withdraw from:  *
Which BILLING CYCLE would you like to withdraw from? IMPORTANT: The date selected means you will cease both lessons and billing on that date. Lessons will not be reserved or billed until you re-register for lessons, or are moved off of the waitlist once space becomes available.  *
Are there additional LESSON ENROLLMENTS you wish to keep active? IMPORTANT: All makeup tokens have a 1 year expiry from the date they were issued. Tokens will remain on your account until used or expired. You do not have to remain enrolled in regular lessons to use your makeup tokens.  *
If you are currently on the waitlist, please let us know specifically which lists to remain a part of, or to be removed from. IMPORTANT: If you remain on a waitlist, you will be automatically registered and billed for a space as soon as it becomes available.  *
PARENT/GUARDIAN First & Last Name:  *
PHONE NUMBER:  *
How would you rate your experience at AquaTech Swim?  *
What would you advise AquaTech to improve on?  *
Were there any specific staff members that stood out to you?  *
Additional Comments: 
A copy of your responses will be emailed to the address you provided.
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