Name *

First Name

Last Name

Terms and Conditions *

- I understand that by entering this payment plan, I will have to pay in full for the next term.-I give permission for Addictive Pole Fitness-Underwood to alter my weekly direct debits to the agreed payment plan amount specified amount. - My payment plan amount will be direct debited from my bank account on Monday. - I understand I can still attend my classes at Addictive Pole Fitness-Underwood while I am on a payment plan, providing my payment is made each week on the agreed day. - Failure to meet my payment plan will result in my account being suspended until the entire outstanding amount is paid in full (not just the payment plan amount for that week). This means I will not be able to attend classes until my TOTAL outstanding amount is - My payment plan will remain in place until the outstanding amount is paid in full, as per my contract. - Once all amounts are repaid, my contract will be considered fulfilled and then terminated by Addictive Pole Fitness-Underwood. As mentioned above, next term I understand I can attend classes providing my membership is paid in full.

I hereby declare that I have read and understand the Terms & Condition of this Payment Plan Request