Competitive Withdrawal

DACA 1080 S. De Anza Blvd. San Jose, CA 95129 (408) 253-7946 (office) (408) 253-6443 (fax)	Must be received no later than the 21st of the month prior to first day of the month you intend to stop swimming.
Student (1):
Student (2):
Student (3):
Parent/Guardian's Name:
Parent/Guardian's Email Id:
Effective:	The first day of:
Example Time Table:	A Cancellation received before February 21st - Withdrawal will be effective March 1st. A Cancellation received after February 21st - Withdrawal will become effective April 1st.
Reason for Withdrawal:	Scheduling Conflict Moving Other
Medical:	Short Term (will return with doctor's release - hold membership) Long Term (unsure of return - cancel membership) Short term medical withdrawals (a maximum of two months) are treated as a leave of absence and a doctor's note is required. Though your child's space will be held, your account remains active and your service hour obligation remains unchanged. You will continue to receive email updates.
I understand that my withdrawal must be received by the 21st of the month prior to the first day of the month I intend to stop swimming. All cancellations become effective on the first of the month. All withdrawals are final. If I change my mind, I must re-register and I understand that registation is on a space available basis. I understand that my account must be paid in full before the cancellation becomes effective.
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