Instructions: This form cannot be submitted electronically. Print it, fill it out and return it to the AHRMA National Office by mail (2375 Midway Rd SE, Bolivia, NC 28422) or fax (910-253-8313). The refund policy is found in section 4.7a of the AHRMA Handbook.
Name: Date:
Number: / Event: Class: Member Comp.
I would like a Credit/ Refund for the above event/class due to the following:
I understand that full consideration will be given to my request, and it will be handled in accordance with the current rules. I will be notified of the decision, with any denied requests in writing.
Signature of Racer
Request Granted Check # attached.
Request Denied Reason for denial:
Date: AHRMA Official If you wish to have your refund by credit card please provide the following information: Credit Card Type:_________________ Card Number:________________________________________ Exp Date:________________________ 3 Digit Security Code:______________________ Name as it appears on Card:_________________________________ Signature:_________________________________________________