Refund and Return Form

If you are unable to attend a program, please review the refund policy and submit a refund form. Due to the high volume of activities during our Summer Lakeside Chautauqua Season, it may take up to two weeks to process your request. We appreciate your patience and understanding. Please note, Rhein Center Classes are non-refundable.

Question Title

* 1. Payee Name & Contact Information:

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Name of Program Registrant:

Question Title

* 3. Receipt Number (found on confirmation email or receipt):

Question Title

* 4. Program Class Name:

Question Title

* 5. Program Class Date:

Question Title

* 6. Additional Comments or Questions: