APPLE VALLEY HIGH SCHOOL
ATHLETIC DEPARTMENT
ATHLETIC FEES REFUND
Date
Grade
Amount
Sport
Student’s Name
Student ID #
Parent/Guardian’s Name
Address
City/Zip
Reason for Refund (after first week)
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Coach
,
The above student is withdrawing from your team. If he/she has turned in all equipment
issued to them, please sign your name and return this form to Kathy Gustafson as soon as possible.
Thank you.
Coach’s Signature
The above student has met the Apple Valley High School requirement for a refund in the
amount of $
for the sport of
.
Athletics Director
Apple Valley High School