Forest Mere Health Club Membership - Champneys

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Please fill in the whole form using ball point pen and send to: Instruction to your Bank or Building Society to pay by Direct Debit CHAMPNEYS FOREST MERE LTD Liphook, Hampshire, GU30 7JQ Telephone: 01428 726013 Fax: 01428 723501 www.champneys.com Originator’s Identification Number 8 0 6 7 9 2 Name(s) of Account Holder(s) Reference Number Bank/Building Society account number Instruction to your Bank or Building Society Please pay CHAMPNEYS FOREST MERE LTD Direct Debit from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. Branch Sort Code I understand that this instruction may remain with CHAMPNEYS FOREST MERE LTD and, if so, details will be passed electronically to my Bank/Building Society. Name and full postal address of your Bank or Building Society Signature(s) To: The Manager Address Post code Date Banks and Building Societies may not accept Direct Debit Instructions for some types of account. The Direct Debit Guarantee • This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit scheme. The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society. • If the amounts to be paid or the payment dates change CHAMPNEYS FOREST MERE LTD will notify you 10 working days in advance of your account being debited or as otherwise agreed. • If an error is made by CHAMPNEYS FOREST MERE LTD or your Bank or Building Society you are guaranteed a full and immediate refund from your branch of the amount paid. • You can cancel a Direct debit Payment at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.
Forest Mere Membership Fees – 2013 Premier Joining Fee Annual Fee Monthly Fee Single £175.00 £1,415.00 £135.00 Joint £275.00 £2,095.00 £205.00 Premier Membership Time of use Mon - Fri 6.30am - 10.00pm Sat - Sun 6.30am - 9.30pm Standard Plus Joining Fee Annual Fee Monthly Fee Single £125.00 £1,040.00 £100.00 Joint £210.00 £1,620.00 £160.00 Standard Plus Membership Time of use Mon - Fri 6.30am - 10.00am & 6.00pm - 10.00pm Sat - Sun 6.30am - 9.30pm Standard Joining Fee Annual Fee Monthly Fee Single £75.00 £660.00 £70.00 Joint £125.00 £1,150.00 £110.00 Standard Membership Time of use Mon - Fri 6.30am - 10.00am & 6.00pm - 10.00pm Sat - Sun 6.30am - 9.30am & 5.30pm - 9.30pm Weekday Joining Fee Annual Fee Monthly Fee Single £75.00 £660.00 £70.00 Joint £125.00 £1,150.00 £110.00 Weekday Membership Time of use: Monday to Friday 9am-3pm
Page 1 and 2: Forest Mere Health Club Membership
Page 3 and 4: Terms & Conditions The Company Refe
Page 5: Please enclose two passport photogr

Forest Mere Health Club Membership - Champneys

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