Reimbursement of recreational fees

Information needed to process the request

First and last name of parent or guardian*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

E-mail

Child's first and last name*

First Last

Child's date of birth*

Description of activities and recreation

Description of activities and recreation*

Organizing organization or company*

Cost of activities and recreation*

Description of activities and recreation

Organizing organization or company

Cost of activities and recreation

Description of activities and recreation

Organizing organization or company

Cost of activities and recreation

The following documents are attached to the application:*

Proof of residence of parent/guardian

Child’s last report card

Receipt for payment of the activity registration fee

Letter or email from the organization responsible for organizing the recreation and activities stating that the child participated in 50% or more of the activity or recreation

File*

Drop files here or

Max. file size: 40 MB.

I acknowledge and certify that all information and documents provided are truthful, I agree that the name of the child to whom the application relates may be disclosed if the latter is granted a refund and I sign this application for refund this :

Date*

Reimbursement of recreational fees

Reimbursement of recreational expenses

Information needed to process the request

Description of activities and recreation