CUSTOMER FORM:

WITHDRAW FROM ONGOING LESSONS

Withdrawing from Lessons and Billing Cycle

If you wish to withdraw from your ongoing lessons and the 4-week billing cycle, please submit the Withdrawal Form no later than 8:00 AM PST on the last day of the current billing cycle.


Important Reminder:
We are unable to offer reimbursements or financial credits for lessons that have already been billed within the current cycle. To help you stay informed, we send billing reminders via email and text to all enrolled customers one week before each billing date.


2026 Billing Dates: 

  • Q1: Jan 14, Feb 11, Mar 11
  • Q2: Apr 8, May 6, Jun 3
  • Q3: Jul 1, Jul 29, Aug 26, Sep 23
  • Q4: Oct 21, Nov 18, Dec 16 

Location:
Withdrawal Reason:

Student Lesson Level:
Day Program Occurs:
Program Time:
Withdrawal Options:
Besides this enrollment, are there any other enrollments to keep active? (EXAMPLE: You have 2 lessons per week and are only withdrawing from 1 lesson per week)
Waitlist Preferences:
If "Other" was selected for waitlist preferences above, please explain:
Parent/Guardian First & Last Name:

Rate your experience at AquaTech Swim:
What would you advise AquaTech to improve?
Were there any outstanding staff you would like to mention?
Additional Comments: