Online Form - Request to Change Membership

Main Opening Hours Table
Monday	5:30am-8:00pm
Tuesday	5:30am-8:00pm
Wednesday	5:30am-8:00pm
Thursday	5:30am-8:00pm
Friday	5:30am-8:00pm
Saturday	7.45am – 11.00am
Sunday	Closed

First Name

Last Name

ERC Membership number (if known)

Address

Street Address:

City:

State:

Post Code:

Country:

Email

Phone

I would like to change my Membership to:

FULL ACCESS MEMBERSHIP - Direct Debit (fortnightly payment)FULL ACCESS MEMBERSHIP CONCESSION - Direct Debit (fortnightly payment)FIT OVER 50 - Direct Debit (fortnightly payment)YOUTH MEMBERSHIP - Direct Debit (fortnightly payment)CORPORATE FULL ACCESS MEMBERSHIP - Direct Debit (fortnightly payment)OCTOLEGEND MEMBERSHIP - 12 Month Upfront payment

I would like my new Membership to commence

I have the following concession card

Not ApplicableSeniors Pension CardLow Income Pension CardDVA CardStudent Card (16yrs+)

Do you wish to update your bank/credit card details for your direct debit payments?

Use the direct debit details you already have for my current membershipI would like to change my direct debit details - please contact meNot applicable

Is there any additional information/questions you'd like to add?

TERMS AND CONDITIONS OF CHANGING YOUR MEMBERSHIP TYPE Your request to change membership types may be declined if your current membership payments are in arrears or you have any outstanding payments. By submitting this online form you acknowledge that you have read and agree to the Terms and Conditions of Membership as outlined on the Eaton Recreation Centre website: https://erc.dardanup.wa.gov.au/membership-terms-and-conditions/