Membership cancellation — dissatisfied with service

We're sorry to see you go!

Please complete the cancellation form below then read and agree to the terms and conditions for cancellation. We will process your cancellation request as soon as possible.

I understand that the effective cancellation date is 28 days from the date this form is successfully submitted and that suspension cannot form part of the 28 day notice period for cancellation. * (required)
I may release my self from any responsibility of a "Minimum Term" agreement by paying a fee of 30per cent of the remaining minimum term. If applicable to your membership, the cancellation fee will be deducted form your last direct debit payable. * (required)
I understand that any suspension time taken does not form part of a minimum membership term. * (required)
Type the characters you see in the image below * (Required)

 

The personal information requested on this form is required primarily in connection with the provision of Council’s Glen Eira Leisure services or administration as indicated in this form. The information will only be shared with those responsible for providing that service/administrative function or as required or permitted by law. This information may be accessed by contacting Council’s privacy officer on 9524 3333. Council’s privacy policy is available on its website at: http://www.gleneira.vic.gov.au/Privacy