Withdrawal Request in San Ramon and Walnut Creek, CA

Withdrawal Request Form

Use this form to withdraw students from the Splash Swim School program.

Parent or Guardian Name * Required
Date * Required
MM slash DD slash YYYY
Student Last Name * Required
Student First Name * Required
Email * Required
Class Day and Time * Required
Withdrawal Date (30 days from today’s date) * Required
MM slash DD slash YYYY
Reason for Withdrawal
Comments
By filling out the form above, I understand that my registration will be cancelled on the withdrawal date. I also understand that Splash Swim School may fill my class day and time (post withdrawal date) at any time after receipt of this withdrawal form. I further understand that if I desire swim lessons in the future, I will need to re-register subject to class availability at that time.