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LSC Refund Request
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* Indicates required question
Email
*
Your email
Player Name
*
Your answer
Player Birthdate
*
MM
/
DD
/
YYYY
Program for which refund is being requested
Your answer
Please explain the circumstances that prevent the player from participating in the program:
*
Your answer
Parent Name (if player is a minor)
*
Your answer
Parent Phone
*
Your answer
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