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Program Withdrawal Request

Please complete this request form if you are registered for a program that is now running, and you would like to withdraw from that program.

As per Recreation Service's program policy, withdrawing from a program after it has started requires a Doctor's note. Approval of the withdrawal at the discretion of the Program Coordinator.

Please submit your information below and the Program Coordinator will respond within 5 business days.

Name of program you are requesting to withdraw from.

First and last name of the person registered into the program

Phone number of person registered for the program.

Please explain why you are requesting a program withdrawal.

Please provide doctors note related to program withdrawal.

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Please provide your email address. A copy of this form will be sent to you for your records.