Required fields are marked with asterisks (*)

Recreation Pass Cancellation Request Form

*Please note that a completed request form does not guarentee cancellation

Participant Information

Recreation pass cancellation requests will be processed for medical / relocating out of Town reasons only. I understand that I will be required to provide documentation.

Yes, I understand

Participant Name:

Address:

Town / City:

Postal Code:

Phone Number:

Pass Information

Pass Purchased

Pass Type:

Reason for Cancellation Request:

Please provide medical / relocating document(s)

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

If approved, how would you like the funds returned?

Account Credit to my Recreation Account (can be used for future programs/services)

Refund by Credit Card (when original payment was made by Credit Card, or financial information is available on account)

Refund by Cheque (please allow up to four weeks for processing)

Full Name:

Email Address

Signature

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Form Builder

Recreation Pass Cancellation Request Form

Participant Information

Pass Information

Stay Connected with Orangeville

Form Builder

Recreation Pass Cancellation Request Form

Participant Information

Pass Information

Stay Connected with Orangeville

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