Mid-Columbia Gymnastics/Elite Force Cheer Withdrawal Form
For recreational students: Withdrawal form must be filled out a week prior to the effective withdrawal month. (Ex: Submit by January 24th to withdraw in February)
Team must meet with coach and submit withdrawal 30 days prior to effective withdrawal month -see team handbook for withdrawal policies.
Parent/Guardian Name:
Your answer
Email:
Your answer
Phone:
Your answer
Student Name:
Your answer
Additional Student Name (If Applicable)
Your answer
Additional Student Name (If Applicable)
Your answer
Effective Month
Reason for Withdrawal:
Please be specific
Your answer
Please discontinue automatic payments to my card on file (if applicable). I understand that my child's spot in class is no longer held once I withdraw. Make ups are only available to enrolled students, any make ups due will be forfeited on effective withdrawal date. Any past balance due on the account must be paid at the time of withdrawal or is subject to being sent to an outside collection agency. I understand that if late notice is given, I am responsible for the classes that have taken place before the date of the form submitted whether attended or not. Annual registration fees are good for one year from the date of payment. Re-enrollment is available at anytime based on availability.
Signature
Your answer
Date:
MM
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DD
/
YYYY
Submit
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