Ezidebit Exit Form
PLEASE NOTE: Payments are direct debited approximately 1-2 weeks prior to the start of each term.
Exit forms must be received prior to the following dates (please indicate which term you are exiting from):
Term 1 Monday 29/01/2018
Term 2 Monday 19/03/2018
Term 3 Monday 11/06/2018
Term 4 Monday 10/09/2018
**IMPORTANT: Any forms received after these dates will apply to the next term
Select a location
Academy & High Performance (Greenacre)
PLC Sydney (Croydon)
Gymnast First Name
Please list class/s wishing to exit from (e.g. Mon L3-6 4pm – 7pm)
Reason for exiting
No longer interested
Change of sport
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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