Fairport Raiders Youth Football and Cheer  

                                                                                             Request for Refund Form  

Requests must be in writing and postmarked 4 week prior the start of the season.  All refunds are subject to 25% of the total registration fee, less a $10 processing fee.  

Date Submitted:   ________________________________________

Parent/Custodian Name that payed the registration fee:  _________________________________

Athlete's Name:   _________________________________________

Circle Player:  Cheer or Football   

Circle Level:      A         B        C        Advanced Flag           K-2 Flag   

Address where refund check is to be sent: (Please allow 2-4 weeks):

_________________________________________________________

_________________________________________________________

Current Phone Number: _____________________________________   

Reason for Refund Request:   _________________________________

_________________________________________________________

_________________________________________________________

Additional Comments:  __________________________________________________________

______________________________________________________________________________

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You may email to:

[email protected]                                                                                                                                                                                                                          
-OR-

Mail your request to:  

FPAA/Refund Request  

PO Box 721  

Fairport, NY 14450