Your Name *

Your Email *

Participants Hockey Canada ID #? *

LAST Name of Participant *

Enter LAST name that matches in Hockey Canada

FIRST Name of Participant *

Enter FIRST name that matches in Hockey Canada

Birthdate of Participant *

YYYY-MONTH-DAY

What program is the participant withdrawing from? *

Is the participant a member of the Tsuut'ina Nation? *

Reason for the withdrawal? *

Name of the person requesting the withdrawal? *

Email Address to receive confirmation of withdrawal? *

Relationship to the member of the person requesting the withdrawal? *

Have you reviewed the refund policy? *

The refund policy can be found on the website for the specific program on the In Season Development page.

The date the form is submitted is used as per the refund policy *

Please verify that you are a human.