Albany SLSC Payment Plan Agreement

Albany SLSC Payment Plan Agreement

Please complete this application form to apply for a payment plan and to be able to register for the 2025-26 season at Albany SLSC. If you have any questions about this payment plan, please contact our Member Services Team via memberservices@albanysurfclub.com.au or registrar@albanysurfclub.com.au. Alternatively, please phone 08 9841 3327.
Name of member applying for payment plan

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list the names of members that you would like included in this payment plan:
Please select the membership categories that you would like to include in this payment plan:
Once your payment plan has been approved, you will be required to pay your membership fees in instalments with the total membership fee paid in full by 23 December 2025. You can opt to select your own instalment dates, or we can send you instalment invoices.
First Instalment

MonthDayYear
Date
Instalment Two

MonthDayYear
Date
Instalment Three

MonthDayYear
Date
Final Instalment

MonthDayYear
Date
Please select your preferred payment method:
Agreement to Payment Plan Conditions
By signing this Payment Plan form, I agree that:
• I am in good standing with the Albany Surf Life Saving Club.
• I understand that this is NOT a direct debit arrangement, I am required to make the instalment payments as per my proposed payment method by my stated due dates
• I understand that I, and/or my family cannot represent the Albany Surf Life Saving Club in any sanctioned events, carnival, competitions, or leadership opportunities until I have paid my/our membership fees in full.
Signature
Should be Empty: