Membership Suspension Please complete the form below to make a request to temporarily suspend your membership. "*" indicates required fields CompanyThis field is for validation purposes and should be left unchanged.Name* First Last Email* example@example.comMobile*0400 000 000Debit Success Reference NumberYour ref. number can be found in your welcome email Your Membership Type– Select –Health & Fitness MembershipAquaticsSwimming LessonsYour Membership Type– Select –Health ClubGymnasticsSuspend Membership from* DD dash MM dash YYYY Suspend Membership to* DD dash MM dash YYYY Reason for Suspension*If applicable, please attach proof of medical certificateAccepted file types: jpg, png, pdf, Max. file size: 4 MB. Please remove any sensitive information from your attachment (eg. Medicare card details)I agree to Terms and Conditions*Consent* I, the undersigned, request to suspend my membership for the time frame above as per the terms of my Direct Debit Request (DDR) and Contract. I understand that I can suspend my membership at $5.00 per week for a maximum of 6 weeks. I understand that if my account is in overdue status, I must arrange to pay all monies owing before a suspension can be processed. I consider my membership to be suspended for the dates i have requested unless i am notified otherwise from the customer care team via email. I understand that i need to give 3 days notice to suspend my membership to avoid future payments being deducted.*This field is hidden when viewing the formSourceManage My MembershipCancellation FormThis field is hidden when viewing the formVenue Name
