Upgrade/ Downgrade Form
* Applicable for Direct Debit memberships only. Excludes Salary Sacrifice memberships.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
I would like to upgrade or downgrade my membership?
*
Upgrade
Downgrade
Current Membership Type
*
Bronze
Silver Bunker/ Rejuvenate
Silver Reformer
Gold
Change my membership to...
*
Bronze
Silver Bunker/ Rejuvenate
Silver Reformer
Gold
This change will start from my next debit date on a Friday
*
-
Day
-
Month
Year
Date Picker Icon
I am happy for admin to process my change of membership with my current saved bank details.
*
Yes, please use my current bank details if saved in my profile.
No, I will need to change my bank details- (admin will contact you once they receive this form)
Any additional notes
Signature
*
Submit
Should be Empty: