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 2024-25 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.
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:*

$400 Family - 2 Adults + 2 Children (U18)$450 Family - 2 Adults + 3 Children (U18)$500 Family - 2 Adults + 4 Children (U18)$100 Little Nipper (Under 6 and U7)$155 Nipper (U8 to U13)$75 Nipper Parent$155 Youth (U14 to U19)$155 Active Senior - Student (evidence required)$190 Active Senior$190 Long Service$60 Social Membership
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 2024. You can opt to select your own instalment dates, or we can send you instalment invoices.*

Choose my own instalment dates (please select below)Albany SLSC to select instalment dates and send invoice
First Instalment

MonthDayYear
Date
Instalment Two

MonthDayYear
Date
Instalment Three

MonthDayYear
Date
Final Instalment

MonthDayYear
Date
Please select your preferred payment method:*

Online bank transferSLSA Portal paymentCash
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 will make the required 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*

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