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2. 
4. Participant's First & Last Name*
5. Parent/Guardian's First & Last Name (if applicable)
7. Email*
8. Contact Phone #*
10. Current Course*

    Please provide the name of the class or program that you are currently enrolled in to withdraw or transfer from.

12. Please select either "Option 1" or "Option 2" below:
14. Option 1: Refund Request Preference
    -- Select One --Account CreditCredit Card RefundCheck Refund

    If you are requesting to withdraw, please select your desired refund method from the dropdown menu above.

    Account Credits will not be assessed a fee. 

    Credit Card Refunds are subject to a 15% processing fee and available if you originally paid via credit card, in person or online. 

    Check Refunds are subject to a 15% processing fee and may take up to four weeks to process. 

    Cash refunds are not available. 

16. Option 2: Transfer Request

    Please indicate the program name above to which you would like to transfer.

    If your request is to transfer to a higher priced class or camp, the cost difference is due upon your request. if you are transfering to a lower priced course, the fee difference will be applied as an Account Credit. 

18. Reason for Withdrawal or Transfer Request*
    -- Select One --Time, date, or schedule conflictDissatisfied with structure/content/instructor after first class.Medical (Please upload Doctor's note below.)Other (Please explain below.)
20. If you selected "Other," please explain:
21. If you selected "Medical," please upload a Doctor's note.
23. I have read and agree to the above. Participant or Parent/Guardian Signature:*
24. Date:*
26. If you have questions, please contact Cecilee Fannon at cfannon@prospertx.gov or 972-569-1057.
28. Prosper Parks & Recreation | 409 E. First Street, Prosper TX 75078 | 972-569-1160
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

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