Update Your Membership - The Gap Health & Racquet Club

Update Your Details

Name*
First Last
Current Email*
New Email*
Phone/Mobile*
Address*
Street Address City ZIP / Postal Code
Date of Birth*
Occupation
Update Your Emergency Contact
Name
Phone
Membership Selection
Confirm Your Membership Level
Are you are Student or Concession Card Holder?
Would you like to commit to a minimum 6 months Membership?*
Total Per Week
$ 0.00
Membership payments are deducted fortnightly from your nominated bank account or credit card. Transaction fee of $1.25 per fortnight applies.
Direct Debit Authority
This section forms part of your Updated Membership Agreement. Payments are transacted within 48 hours of completion of this online Membership Form.
I request the GHRC - ABN 86 056 961 409 to arrange for funds to be debited from my nominated credit card or bank account detailed below in accordance with this membership agreement.*
- Yes, I accept
I accept the GHRC Term & Conditions*
- Yes, I accept
Click to view Terms & Conditions
Update Your Payment Type
- Credit Card
- Bank Account
- No Change
Card Holders Name
BSB
Credit Card Number / Account Number
Expiry Date
Month*
Year*
CVV*