Request for Refund for 2010 Entries

This form is only for participants who did NOT enter and pay through motoregistry.ca. If you entered through motoregistry.ca and paid via PayPal just log into your motoregistry.ca account and cancel your entry there. Refunds will be credited to your PayPal account.

For security reasons a written request for refund must be submitted. Following is a checklist  of information which must be confirmed before refunds are issued .

• deadline for refund request August 10
• complete one request for refund for each class
• administrative deductions:
  
  • Before June 20 $0
  • After June 30 $10 per entry
  • After July 31 $20

     

Rider Name ----------------------------------------

Class ----------------------------------------

Motoregistry Entry Number (if available) ---------------------------------------

Reason for cancel -------------------------------------------------------------------------------------------------------------------


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Ensure that staff can confirm the following information:
..........................................................................................................................................................

For office use:

• written request submitted yes / no
• did the rider enter the class(es) requested yes / no
• how did the rider enter online / mail / courier / at event
• was payment transferred to another entry yes / no
• how was payment recorded Paypal / money order / check / cash
• if paid by cheque did it clear the bank OK yes / no
• what was the amount of original payment $80 / $85 / $90 / $95 / $100
• refund request reviewed and approved by  yes / no
• Paypal paid entries refunded by  yes / no
• cheque payments issued by  yes / no

   

Net amount refunded -------------------------------------


Date --------------------------------------


Approved ----------------------------------------


Rider Signature For Received Refund ----------------------------------------