Request and Authority to Debit
Request and authorise SOUTH PACIFIC HEALTH CLUB to arrange, through its own financial institution, for the amount of
$25.00 fortnightly debit or charge you through the Bulk Electronic Clearing System from an account held at the financial
institution identified below and paid to the Debit User, subject to the terms and conditions of the Direct Debit Request Service
Agreement (and any further instructions provided below).
Swim School Terms and Conditions at St Kilda Sea Baths
I hereby authorise the South Pacific Health Club to debit my: