WA COVID Membership Suspension Request Application Form

Please complete form below to request to suspend my membership until state government announce reopen.

Note: Please see your recent membership email for your billing reference number. You will find the reference number at the top of your email.

Terms and Conditions

I, the undersigned, request to suspend my membership for the duration of the latest COVID-19 announcement by the Western Australian Government made on Monday 28 June 2021*. I also understand that any time spent on suspension will be added onto the minimum term of the Agreement. I understand that if my account is in default I must arrange to pay all monies owing before a suspension can be processed. This form is only a membership suspension application form and if your suspension is outside your terms and conditions your membership is not considered suspended until you receive confirmation from Genesis Health + Fitness or Debitsuccess.

*This period is subject to change in line with revisions from the state government.