Capricornia School SportPh: (07) 4932 4045

PO Box 138Fax: (07) 3220 6533

ROCKHAMPTON QLD 4700ABN: 99 357 991 871

Email: bsite:

FORM 11 – REQUEST FOR REFUND

I, ______, being the parent/carer/sponsor of ______

request a refund of $______paid for______

Full name of team______

I request a refund due to:______

______

I understand and agree that:

  1. a refund may not be made to me,or be made in full, or in part, having regard to the associated expenses already incurred by Capricornia School Sport, and the Capricornia School Sport’s refund guidelines provided to me.
  2. a copy of the receipt for the original payment is attached / not attached.(Please circle)
  3. a copy of the signed withdrawal form must be attached if requesting a levy refund.
  4. my details will be kept confidential and will not be used for any other purpose.
  5. my refund will be made by bank deposit.

______/______/______

Signature of Parent/CarerDate

Address:______

______Postcode______

Contact Number/s:______

Contact email address:______

Bank Details: BSB: ______A/C No: ______A/C Name: ______

PLEASE NOTE: If Refund Requests are not completed in full your refund may be delayed.

(CSS Office Use Only)

Original Receipt Number:______Amount Receipted: $______Amount Requested: $______

□APPROVEDRefund Amount Approved: $______□NOT APPROVED

______/_____/____

Signature of RSSODate

Refund Guidelines for Capricornia School Sport

At Capricornia School Sport, we are committed to providing a safe and supportive learning environment for students, staff and volunteers. This commitment includes the health and safety of staff and students when conducting curriculum activities in the school or in other locations.

School excursions and camps enhance a student’s learning by providing opportunities for the student to participate in activities, both curriculum-related and recreational, outside the normal school routine. All planned school excursions are approved by the Regional Director and endorsed by Capricornia School Sport Board.

Capricornia School Sport is able to charge a fee for:

  • an educational service including materials and consumables not defined as instruction, administration and facilities for the education of the student
  • an education service purchased from a provider other than Capricornia School Sport where the provider charges Capricornia School Sport and
  • a specialised educational program.

A Capricornia School Sport fee is directed to the purpose for which it is charged.

Capricornia School Sport levies are calculated on a cost recovery only basis, according to the number of students who have indicated their attendance.

Participation of students in a representative team is indicated through payment of the individual levy and provision of a permission form completed by the parent/carer.

As the Capricornia School Sport budget cannot meet any shortfalls in funding for an activity due to the subsequent non-participation of a student who had previously indicated attendance of the activity, fees already paid for an extra-curricular activity may be refunded in full or in part or not at all, having regard to the associated expenses incurred and the circumstances of the non-participation.

If a parent/carer wishes to apply for a refund due to their child’s non-participation in a representative team, they may do so by completing a Request for Refund form available from the Capricornia School Sport office. Where possible, the request should include the receipt relating to the payment for which a refund is being sought.

Department of Education, Training and Employment policy references:

Education (General Provisions) Act 2006

PPR: School Excursions

PPR: State Education Fees