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2. You do not need to sign in to complete this form
4. We are sorry that you are not completely satisfied with the recreation program in which you (or your child) were registered. Our purpose is to satisfy your leisure needs. Please help us by offering your opinions about how we can improve this program.
   Your refund request will be submitted to the appropriate Supervisor for review.
6. Contact Information
8. First Name*
9. Last Name*
11. Participant's Full Name*
13. Phone Number*
14. Email Address*
16. Name of class or activity*
17. Activity #
19. How did this program fail to meet your needs (your child's needs)?*
21. What changes could be made to the program in relation to class content, instructor(s), instructor's approach, location to match your expectations?
23. Was there anything you liked about the program?
25. Other Comments?
27. Do you have any suggestions for other programs the Campbell Recreation Department could offer in the future?
29. This is a request only
    Staff will respond within 48-72 hours of this submission with a response to your request.
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

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