SCG Withdrawal Form

Respondent

You will receive a confirmation by email.

First name *

Last name *

Email *

Mobile *

Student

First name *

Last name *

Date of birth

Name of class you would like to be withdrawn from *

Date & Time of Class *

Reason for withdrawing *

Scheduling Conflict Injury Moving Other

If other, please explain:

I understand that a $20 admin fee will be withheld from my cancellation, and that the refund will be prorated based on the SCG Class policies (found here).

I have read and accept *

Electronic signature

Please sign your name inside the box.