Suspension Request

Please complete the form below if you would like to suspend your Yarra Leisure membership.

Members on direct debit are permitted two months (sixty two days) suspension per calendar year. Term membership suspensions are limited for 3 and 12 month term memberships as follows:

3 month term membership – 31 days per contract
12 month term membership – 62 days per contract.

Suspensions are to be made with a minimum period of two weeks and cannot be backdated.

Completion of this form does not confirm suspension of your membership. You will receive confirmation via e-mail once the suspension has been processed with a reference number for your records.

Fields marked with an asterisk () are mandatory.

Your Details

First Name:

Last Name:

Address:

Mobile:

Home:

Email:

Membership Details

Membership number:

Membership type:

Suspension

I understand that my membership will automatically reactivate from the dates specified and that refunds or additional time will not be given if my membership is reactivated and I have failed to notify Yarra Leisure of additional suspension requests in writing.

I understand that if I have not provided my suspension request by the 25th of the month, my request will be processed as part of the following month’s Direct Debit.

• Suspensions for memberships are available for a minimum of two weeks.
• 3 month term memberships have a maximum of 31 days per calendar year.
• 12 month term memberships and monthly debit memberships have a maximum of 62 days per calendar year.

I wish to suspend my membership from:

To:

I have read, understood and accept the above terms and conditons:

Completion of this form does not confirm suspension of your membership. You will receive confirmation via e-mail once the suspension has been processed with a relevant reference number for your records.