Your contact details So we know who to notify when the refund has been processed or who to contact if we have any questions.Your full name*Your email address* Your best contact phone numberRegistration Transaction Details Most of this data can be exported from the PlayFootball website, but it saves us a significant amount of time if you can complete as much information as you can so we can match to the transaction and process the refund. Your FFA Invoice Number*This is the name of the attachment included in the email sent to you after you completed the registration. The email subject line would've been "Your registration to Football - Pending Approval".Registered player's FFA number*listed on the invoiceRegistered player's nameDid you use an Active Kids voucher with this registration?YesNoRefund amount requestedRefund request reasonPlease selectSelected incorrect registration productAccidental double-up on paymentDecided to withdraw from playing this seasonIncorrect amount paid (for rego's between 01/02/2022 and 26/03/2022)Transferred to another clubRegistered player's age bracketPlease select6s - 7s ($100 rego)8s - 11s ($110 rego)12s - 18s ($130 rego)Seniors ($240 rego)Your bank account details Please ensure you enter the correct details here. See conditions at the bottom of this form. We will use the INV_xxxxxxxx you provided above as the transaction reference.Your bank account name*Your BSB number*Your account number*Please note the following conditions * Great Lakes United Football Club will only process refunds for the difference of the incorrect registration payment and the advertised registration costs for rego overpayments between 1 February and 26 March 2022. * Transfers to other clubs or withdrawals from playing will be confirmed with coaches and other clubs before processing any refunds. * All above registration transaction details will be verified before any refunds are processed. * Great Lakes United Football Club takes no responsibility for incorrectly entered bank details or lost monies. If you performed multiple registrations and payments before we discovered the pricing issue, unfortunately you will need to complete the form for each transaction.Acknowledgement of above conditions* I confirm that I have read and understand the payment refund process and conditions NameThis field is for validation purposes and should be left unchanged.