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Ezidebit Exit Form
PLEASE NOTE: Coaching schedules and billing for the following term occurs on the last day of the existing term. All exit forms must be received prior to the end of term
Select a location *
Gymnast First Name *
Your answer
Gymnast Surname *
Your answer
Parent Name *
Your answer
Contact Number (please put +61 instead of 0 at the start of your mobile number) *
For example: if your number is 0412 345 678 then you would write +61412345678
Your answer
Email Address *
Your answer
Reason for exiting *
Do you think you would return to Rhythmic Gymnastics in the future? *
I wish to exit my Direct Debit arrangement with Ezidebit / Le Ray Gymnastics *
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