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Aquatic and Recreation Centre Membership Cancellation or Suspension

Before You Start

There are some hard words in this application. The hard words are in blue. You can read what they mean on our definitions page .


There are some rules for membership suspensions, please read them before applying for a suspension.

  •  You must ask for the suspension or cancellation in writing 10 days before your next direct debit
  • Suspensions must be applied for before the suspension starts. Suspensions will not be back dated.
  • Suspensions must be a minimum of one week.
  • Suspensions cannot be longer than one month.
  • Your membership and all costs will resume on the suspension end date stated in this application. If you need a longer suspension you must apply again.


Fields marked with an asterisk (*) must be completed
Your Details
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Is this application for a suspension or cancellation? * (required)
Please select centre
Phone Number
Suspension of Membership
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Have you suspended your membership before?
Cancellation of Membership
Reason for cancellation

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Customer Satisfaction Survey (1 being poor and 7 being great)
How would you rate the customer service? * (required)

How would you rate the gym facilities? * (required)

How would you rate the pool facilities? * (required)

How would you rate the accessibility? * (required)

How would you rate the cost? * (required)

Please enter the code from the image to continue


    Privacy Statement

    The East Gippsland Shire Council asks for details about you to collect rates, approve permits and licences, and run a range of community services.  The information you give to us on this form is used only for the reasons set out in the form and is not given to anybody else. Sometimes we may supply details about you to someone else, but only if we are allowed by law, or to protect someone or property.

    When information is given out, Council will always try to make sure your privacy is protected in line with the Privacy and Data Protection Act 2014.  You may ask for more information about Council’s Privacy Policy by contacting our Information Privacy Officer on 03 5153 9500 or e-mail feedback@egipps.vic.gov.au


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