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2. Please fill out this form to process a refund for a Liberty Parks & Rec cancellations. Your information will be submitted to administrative staff and they will process the refund. Please allow 3-5 business days for credit card refunds and up to two weeks for a check refund.
4. HOUSEHOLD INFORMATION:
6. First Name:*
7. Last Name:*
9. Address*
10. City/ State*
11. Zip Code*
13. Phone Number:*
14. Email Address:*
18. PROGRAM INFORMATION:
20. Name of person(s) registered*
21. What program did you register for?*
23. Address to send refund
    only applies to those who have paid with cash or check. Check refunds may take up to two weeks. Credit card payments will be applied back to credit card.
24. Who should we make the check payable to?
    only applies if you paid with cash or check
26. Comments:
    (Please limit to 100 words or less)
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field