2020-2021 LSMHA Refund
 All players will receive a 100% refund of funds paid for the second half of the LSMHA season.  Please complete this form ONLY if you would like a refund issued via cheque.  If you do not fill out this form, the refund will be rolled over and applied to the 2021-2022 season for your child.
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Name of Player & Division Played.  Please list all children that you are requesting a refund for.  For example, Mike Smith (U15), Rachel Smith (U13). *
Name of Parent (Who the cheque will be issued to). *
Mailing address (including POSTAL CODE) *
Phone number (in case we have questions) *
By clicking this box, I agree that I am the guardian that submitted payment for my child and therefore am entitled to reimbursement. *
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