Refund Request In order to be considered for a class/program refund we ask that you completely fill out and submit the following form. There will be a $5.00 cancellation fee assessed to all refund requests that are granted unless stated otherwise. Refunds can take up to 30 days from start to finish. If you should have any questions regarding the refund, please contact the program supervisor of the class you are requesting the refund for. Inquiries can be directed to 847.965.1200. Today's Date* MM slash DD slash YYYY Registrant's Name First Last Activity Name* Activity Number (see receipt)* Date of Last Class Attended (if applicable) MM slash DD slash YYYY Was the Supervisor notified?* Yes No Reason for Refund* Low enrollment Medical excuse Schedule conflict Child does not wish to attend Unhappy with class Weather Instructor cancelled class Family Emergency