RISE Refund Request Form

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Refund Request Form

Program Details

Program Location *

Program Date *

Reason for Refund *

Injury / Illness
Adverse weather - sessions cancelled
Sessions / Program cancelled by NRL
Program rescheduled or relocated
Participant cancellation - 5 business days prior notice required
Other

Details of Payment to be Refunded

Participant Name *

NRLID *

Email Address *

Date of Payment

Amount Paid *

Bank Details for Refund

Financial Institution *

Account Name * e.g. J R Smith

BSB *

Account Number *

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