Recurring Payment Form

Recurring Payments Form

This form is to be used by customers of Rockburn Ltd wishing to start a recurring payment via Direct Debit with Rockburn Ltd for subscription-based membership.
Terms and conditions of memberships

- this form is only to be completed if recieved after a discussion with a member of staff at Rockburn Ltd - disregard in all other instances.

- payments are taken from the 1st of the month

- if you subscribe after the 1st of the month, a pro-rated payment will be required for the remainder of the current month; once paid, full membership benefits will commence. Thsi payment will be made on your next visit to Rockburn Ltd, upon check-in.

- Rockburn Ltd requires 5 days notice in order to amend/cancel subscriptions, subject to a minimum term being fulfilled. As of 1st January 2019, the minimum term is 3 months subscription.

- if cancellation is requested and the minimum term is not reached, the remainder of the minimum term may be charged. This excludes a 14-day cooling off period after the initial payment for the subscription. Any climbs used in this time will be charged to the account at standard centre PAYG rates.

- failed payments may be subject to an administration charge of £5. this is to cover the cost of chasing payments and to cover costs incurred via our payment portal for failed payments.
I acknowledge my acceptance and agreement to the Terms and Conditions set out in the above statements: *

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Name of Signatory *

First Name Last Name
Signed on: *

Day Month Year
Date
Membership Subscriptions
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Monthly Recurring ( £ 35.00 GBP for each month )

Climbing Club Subscription ( £ 30.00 GBP for each month )

U18 Monthly Membership ( £ 30.00 GBP for each month )
Data Protection and Privacy Information

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Recurring Payments Form