Disclaimer
Direct Debit Service Agreement
I authorise Ezidebit Pty Ltd ACN 096 902 813 (User ID No 165969, 303909, 301203, 234040, 234072, 428198) to debit my/our nominated account identified above through the Bulk Electronic System (BECS) in accordance with the Debit Arrangement stated above by, and as per the Ezidebit Direct Debit Agreement Terms & Conditions.
I declare that I am medically and physically fit and free from impairment, and able to participate in fitness activities. I have undertaken or will undertake all necessary medical and/or fitness assessments and examinations. I agree to obtain medical clearances if requested by City of Melville prior to commencing exercise. I also agree to inform the site immediately should any of the information on this form change. I assume with full knowledge the dangers in my participating in fitness activities and do so at my own risk and I agree to the Conditions of Entry Terms and Conditions.