membership changes form. • BlocHaus Bouldering Sydney

BlocHaus SYD membership change request form

"*" indicates required fields

name*

first name last name

email*

phone*

change request type*

cancel membership

pause membership

switch to a different membership (only for mini & all-haus direct debit members)

transfer a mates or family membership seat (only for primary owners)

current membership type*

all-haus direct debit

mini direct debit

membership type for cancellation*

single membership (all-haus, mini or paid in full)

shared membership (mates or family)

membership type for pause*

single membership (all-haus, mini or paid in full)

shared membership (mates or family)

are you the original purchaser of the shared membership?*

yes (only the primary owner can cancel a shared membership)

are you the original purchaser of the shared membership?*

yes (only the primary owner can pause for all members on a shared membership)

no (I’m only requesting a pause for myself)

would you like to pause the full membership or individual member/s?*

just myself

other member/s (please provide their details at other info below)

all members

please confirm you understand that your shared membership will be cancelled in full for all members*

yes (no single person cancellations permitted)

what type of membership would you like to switch to?*

all-haus direct debit

mini direct debit – Melbourne

mini direct debit – Mitchell

mini direct debit – Leichhardt

mates or family direct debit

what type of membership would you like to switch to?*

mini direct debit – Melbourne

mini direct debit – Mitchell

mini direct debit – Leichhardt

mates or family direct debit

what type of membership would you like to purchase? (you will be the primary owner)*

mates membership

2 person family membership

3 person family membership (max 2 adults)

4 person family membership (max 2 adults)

5 person family membership (max 2 adults)

please confirm your mate or family member/s have a valid BlocHaus (Approach) profile & are ready to be added to your new membership:*

(they can set up a profile in our customer portal)

yes – please provide their details below

membership type for seat transfer*

mates membership

2 person family membership

3 person family membership

4 person family membership

5 person family membership

are you the original purchaser of the membership?*

yes (only the primary owner can transfer a shared membership seat)

how many membership seats are you seeking to transfer?*

one

two

how many membership seats are you seeking to transfer?*

one

two

three

how many membership seats are you seeking to transfer?*

one

two

three

four

member to remove*

first name last name

second member to remove*

first name last name

third member to remove*

first name last name

fourth member to remove*

first name last name

please confirm your mate or family member/s have a valid BlocHaus (Approach) profile & are ready to be added to your new membership:*

(they can set up a profile in our customer portal)

yes – please provide their details below

member to add*

first name last name

member to add email*

member to add phone*

second member to add*

first name last name

second member to add email*

second member to add phone*

third member to add*

first name last name

third member to add email*

third member to add phone*

fourth member to add*

first name last name

fourth member to add email*

fourth member to add phone*

second member name*

first name last name

second member email*

second member phone*

third member name*

first name last name

third member email*

third member phone*

fourth member name*

first name last name

fourth member email*

fourth member phone*

fifth member name*

first name last name

fifth member email*

fifth member phone*

when would you like your new membership to start?*

7 days from today (you’ll be charged again for your current membership if it falls due before then)

your next billing date after the 7 day notice period

membership cancellation date (min 30 days from today)*

membership pause start date*

membership pause end date*

any other info or questions?

BlocHaus SYD membership change request form

MKV

LCT

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