Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Request for Monthly Pass Cancellation Form

  1. Terms and Conditions of Cancellation Policy*
    - Evergreen Park & Recreation District requires a 30-day notice for all monthly facility passes to be cancelled; meaning an additional payment will be taken if this request is submitted after the first of the month.
    - If you have not met the minimum requirement of 3 full months of payments, additional payments will be taken to equal 3 months of payment in full, prior to the cancellation of the pass.
    - Any past due amounts will be collected at the time of the final payment.
  2. Please read and acknowledge the following statements:
  3. Acceptance Required*
  4. Acceptance Required*
  5. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.
  6. Leave This Blank:

  7. This field is not part of the form submission.