Slater: Electronic Debit Order Mandate

Electronic debit order mandate for under 21's only.

Email Address*
Club (Slaters Gym Branch)
Fundraiser Name
Promo Code
Not compulsory
Transaction
Person under 21 details
Name*
First Last
ID or Passport Number*
Medical Aid Name
Medical Aid Number
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Residential Address
Street Address Complex / Estate, Home Number & Internal Street City State / Province / Region ZIP / Postal Code Country
Find address using Google Maps
Work Address*
Company Name Complex / Estate, Home Number & Internal Street City State / Province / Region ZIP / Postal Code Country
Cell Number*
Parent/Guardian giving consent (If member is under 18)
Name
First Last
ID or Passport Number
Cell Number
Contract:
Contract Type*
Payment Method:
Payment Method
Agreement:
I hereby declare that I am under the age of 21. I understand that I must bring my ID as proof to collect my access card.
I understand a parent/legal guardian must complete and sign the contract if I am under the age of 18.
I understand I have a 5 working day cooling off cancellation period after which no refunds will be processed.
Abbreviated short name as registered with the acquiring bank: SLATER
Refer to our contract reference number (“the Contract Reference Number”):
Reference*
Club Rules and Regulations*
Members agree to obey all the rules & regulations as established by the Management of the Club. These rules & regulations may be amended from time and may be orally communicated or contained on signs posted in the club. Membership/Access Card Membership/Access Cards are for the sole exclusive use of the member. No member will gain access to the club without their card. Members may not loan their access cards to anyone. Should a nonmember present a member’s card, the Club will confiscate the card and the member’s membership may be summarily suspended or terminated by the Club. A fee may be charged to replace lost or stolen access cards. If a card is left at home, access will only be permitted with an ID book or driver’s licence. The Club retains the right to deny access to any members who are in arrears in payment to the Club or who are in default of any of their obligations to the Club. Clothing & Hygiene The Club reserves the right to deny use of the Club to any person whose attire is not considered to be appropriate in connection with the public image of the Club and its rules and regulations. No topless training will be allowed (this rule includes male members!!!). Members are required to use a personal training towel at all times while exercising and shall use the towel to wipe equipment and upholstery. Membership Age Restrictions Family or other membership plans may be available which include minors (12 – 18 years). Such plans may contain restrictions as to days, hours, facilities and services available. Further the Club may require that all minors be accompanied by an adult. That being said there are two hard and fast rules pertaining to minors that are standard throughout the group. 1. NO MEMBER UNDER THE AGE OF 12 YEARS IS ALLOWED IN ANY OF THE CLUB TRAINING AREAS. 2. NO MEMBER UNDDER THE AGE OF 16 YEARS IS ALLOWED TO USE ANY CARDIO EQUIPMENT. These include Elliptical, Treadmills, Cycles, Rowers, Steppers and Spinning Bikes. Child care facilities are provided in all Clubs. Child care facilities are provided at certain times which are advertised in the Club. Medical Aids Medical Aid memberships are only valid as long as the agreement between Slater Health and the respective Medical Aid stays in force and payment is received. Medical Aid memberships are not transferable. Medical Aid memberships will only be in force on instruction from the respective medical aid and may be cancelled at any point with due instruction from such medical aid. Freezing Of Memberships Membership contracts can only be frozen for reasons of medical health or travel. This contract may be frozen for a minimum of 1 (ONE) month to a maximum 3 (THREE) months in a twelve month cycle, for medical reasons or travel. No Debit Order memberships may be frozen. Freezing option is available to pre-paid memberships only. Reciprocal Clubs Slater Health guarantees the reciprocal use of any Club belonging to the group. Please check with reception as to which of the Groups’ Clubs are included in this reciprocal arrangement. The Club does not guarantee or take responsibility for the availability of any reciprocal club not owned by the Slater Group, even though such clubs may operate under the Slater Health name and logo. The member indemnifies the Club against any inconvenience suffered as a result of the above unavailability, whether temporary or permanent undertakes not to institute any claims against the Club in relation to the above. Damage to Club Property Members will be responsible for all costs arising from any damage to Club property whether caused accidentally or intentionally. Closure of Club and/or Alteration of Hours In the event of the Club, in its discretion, deciding that necessary maintenance work should be done to the Club’s premises, the Club may close its facilities for the period required for completion of the necessary maintenance. If at the discretion of the Club Management and due to unforeseen circumstances, a Club has to be closed on a permanent basis, Slater Health reserves the right to provide an alternative facility within a 20km (TWENTY) radius for use by the members. The Club hours will be displayed and the Club Management reserves the right to change the Club hours from time to time or as deemed necessary. Equipment and classes are available subject to demand. Any classes may be discontinued or the time thereof altered, as deemed necessary, at the sole discretion of the Club Management. Pre-Opening Agreements Slater Health reserves the right to enter into agreements with prospective members of a Club, which is to be, or is under construction. Slater Health cannot guarantee the opening date of a new Club under construction. In the event of a delay of any nature whatsoever in the opening of a Club, the member hereby agrees that Slater Health will not be held liable for any such delays. The commencement date of the membership will be deemed to be the opening date of the Club. Valuables and Personal Property The Club will not be held responsible for any loss, theft or damage to personal property of the member, their dependant’s, guests or any third party/ies.
Disclaimer*
- I warrant that I/my child is physically and medically fit to proceed with normal routine of exercise, and the club will not be held responsible for any injury, accident or loss.
Signature*
Signature of legal guardian if member is under the age of 18.

E-Mandate

Electronic debit order mandates for your business.

(LS) #** SL004 – SLATER (ONLINE 21)

Person under 21 details

Parent/Guardian giving consent (If member is under 18)

Contract:

Payment Method:

Agreement: