AYSO Region 143 Registration Cancellation Form
Please complete this form once for each player that you want to cancel from the 2021 Fall program.

Participants dropped by 11:59 PM PST on July 31, 2021 will receive a refund for the REGISTRATION FEE paid, less any discounts and fee credit coupons redeemed. If a Spring 2020 fee credit coupon was used, you will receive your credit back in the form of a new fee credit coupon with an extension through 2/29/22.

As a reminder, the $20 Player Membership fee is non-refundable, but will cover your player for any AYSO programs through the membership year ending July 31, 2022.
Email *
Account Last Name *
Account First Name *
Player Last Name *
Player First Name *
Player Date of Birth *
Player Division *
Mailing Address - Street Address *
Mailing Address - City *
Mailing Address - Zip Code *
Reason for drop
How do you want to receive your refund? *
We will attempt to credit back the original credit card used during registration. Sometimes this isn't an option in our system; if not select how you want your refund.
A copy of your responses will be emailed to the address you provided.
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