Membership Cancellation Please complete the form below to make a request to cancel your membership. "*" indicates required fields URLThis field is for validation purposes and should be left unchanged.Select a MOVEMV Venue*– Select –Keilor East Leisure CentreAscot Vale Leisure CentreSelect a Mornington Peninsula Shire Active Venue*– Select –Pelican Park Recreation CentreCrib Point Outdoor PoolSomerville Recreation CentreCivic Reserve Recreation CentreYawa Aquatic CentreName* First Last Email* example@example.comMobile*0400 000 000Your Membership Type– Select –Health & Fitness MembershipAquaticsSwimming LessonsReason for Cancellation*– Select –MedicalDissatisfied with cleanliness / maintenanceDissatisfied with staff or serviceWanting to try a different activityClasses or program availabilityNo Time, too busy to continueFinancially unable to continueMoving out of the areaJoining another facility or clubPersonal reasonsOtherMoving to another Belgravia FacilityTravelling for an extended period of timeJoined under Workcover/ Funded MembershipsJoined under Fitness PassportWinterGOswim – satisfied with level abilityI agree to Terms and Conditions* Consent* I, the undersigned do hereby request that my direct debit membership be cancelled. I understand that a notice period is required for all cancellation requests (usually 14 days), unless specified otherwise on my contract. I understand that my membership cannot be cancelled while my account has overdue payments and I must pay all monies owing before cancellation can take effect.*This field is hidden when viewing the formURL
