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MDSA Player Withdrawal Form
The $20 AYSO Annual Membership Fee is non-refundable and will not be returned as part of a player withdrawal request. The player will continue to be an AYSO Member for the duration of the 2019 Player Year (August 1, 2019 through July 31, 2020). Please see www.ayso.org for more information.

All player withdrawal requests received by July 15, 2019 (the team building player count lock-in date) will receive a full refund of the Fall Registration Fee minus discounts and including any late fees provided that any equipment that has been distributed to the player has been returned.

All player withdrawal requests received on or after July 16, 2019 will receive a 50% refund of the Fall Registration Fee minus discounts and including any late fees provided that any equipment that has been distributed to the player has been returned.

No Refunds will be issued after August 24th, which is the Fall Season Opening Weekend. If there are special considerations, please include them in the Notes/Comments section of the Player Withdrawal Request. They will be reviewed by the Registrar and Regional Commissioner.

Player Name *
Your answer
Date of Birth
MM
/
DD
/
YYYY
Division/Age Group
Email *
Your answer
Person Submitting Request *
Your answer
Phone
Your answer
Address
Your answer
Notes/Comment/Reason for withdrawal *
Your answer
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