Little Otter Withdrawal Form
Withdraw Student - Huntersville and Charlotte / Matthews
Sign in to Google to save your progress. Learn more
Email *
Parent or Guardian's Name (first and last) *
Which location are you withdrawing your student from? *
Swimmer's name(s) you are withdrawing (first and last) *
Name of the class you are withdrawing from?
What day does your child attend class? *
What is your child's class? *
Time
:
Last date that your child will be attending class? *
MM
/
DD
/
YYYY
What is the reason you are withdrawing this student? (Please check all that apply) *
Required
We will send a withdrawal acknowledgement to the email address provided. If you would like an additional email address to be CC'd please add it here.
By clicking on "Please withdraw by child" and submitting this form, you are agreeing that your registration will be canceled.  You acknowledge that withdrawals are final and in order to return to class a student must re-register. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of R+M Agency.

Does this form look suspicious? Report

Google Forms