Direct Debit Suspension Application Request Form
Select your centre
*
NSW - Andrew Boy Charlton Pool
NSW - Auburn Ruth Everuss Aquatic Centre
NSW - Annette Kellerman Aquatic Centre
NSW - Bathurst Aquatic Centre
NSW - Bernie Mullane Sporting Complex
NSW - Cabarita Swimming Pool
NSW - Drummoyne Swimming Centre
NSW - Fanny Durack Aquatic Centre
NSW - Kurri Kurri Aquatic and Fitness Centre
NSW - Lakeside Leisure Centre
NSW - Michael Wenden Aquatic Leisure Centre
NSW - Michael Clarke Recreation Centre
NSW - Prince Alfred Park Pool
NSW - Singleton Gym and Swim Centre
NSW - Tilligerry Leisure Centre
NSW - Victoria Park
NSW - Whitlam Leisure Centre
QLD - Albany Creek Leisure Centre & Health Club
QLD - Bribie Island Aquatic Leisure Centre
QLD - Burpengary Regional Aquatic Centre
QLD - Caboolture Pool and Fitness Centre
QLD - Cleveland Aquatic Centre
QLD - Dayboro Pool and Gym
QLD - Deception Bay Aquatic and Fitness Centre
QLD - Ferny Hills Swimming Pool
QLD - Fernvale Indoor Sports Centre
QLD - Gympie ARC
QLD - Ingle Farm Rec Centre
QLD - Katanning Aquatic Centre
QLD - Kauri Community and Sports Centre
QLD - Lawnton Aquatic Centre
QLD - Mackay Aquatic and Recreation Complex
QLD - Memorial Swim Centre
QLD - Millmerran Indoor Sports Centre
QLD - Mudgeeraba Aquatic centre
QLD - Murrumba Downs Community Pool
QLD - Nambour Aquatic Centre
QLD - Nerang Aquatic Centre
QLD - North Lakes Aquatic Centre
QLD - Oakey Aquatic Centre
QLD - Pioneer Swim Centre
QLD - Pittsworth Pool
QLD - Redcliffe War Memorial Pool
QLD - Woodford Swimming Pool
SA - Adelaide Hills Recreation Centre
SA - Copper Coast Sport & Leisure Centre
SA - Parafield Gardens Rec Centre
SA - Port Pirie Aquatic Leisure Centre
SA - The Rex Barossa Aquatic Fitness
SA - Waikerie Community Sports Centre
TAS - Smithton Wellbeing Indoor Recreation and Leisure
TAS - Splash Devonport
VIC - Aquarena Aquatic and Leisure Centre
VIC - Ascot Vale Leisure Centre
VIC - Civic Reserve Recreation Centre
VIC - Crib Point Pool
VIC - Faith Leech Aquatic Centre
VIC - Gurri Wanyarra Wellbeing Centre
VIC - Kilsyth Centenary Pool
VIC - Knox Leisureworks
VIC - Melton Waves
VIC - Monbulk Aquatic Centre
VIC - Pelican Park Recreation Centre
VIC - Queens Park Outdoor Pool
VIC - Robinvale Leisure Centre
VIC - Somerville Recreation Centre
VIC - Swan Hill Leisure Centre
VIC - WaterMarc
VIC - Windy Hill Fitness Centre
VIC - Yarra Recreation Centre
WA - Loftus Recreation Centre
WA - B Active East Fremantle
Select Membership Type
*
Health & Fitness Membership
Gymnastics
Aquatic
GoSwim
Name
*
First Name
Last Name
Email
*
example@example.com
Debit Success Reference Number
Please note - your reference number can be found in your initial welcome email
Mobile
*
0400 000 000
Membership Payment Method
*
Direct Debit
Suspend Membership from
*
-
Day
-
Month
Year
Select Start Date (Please pick a future date)
Suspend Membership to
*
-
Day
-
Month
Year
Select End Date (Please pick a future date)
Reason for Suspension
*
If applicable, please attach proof of medical certificate
Browse Files
Cancel
of
I agree to Terms and Conditions
*
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.
Submit Request
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