Festive Season:

Please visit our opening hours page to view our holiday period hours. Please note our stadium will be closed for resurfacing from 23 December to 29 December. Our steam room at GESAC will be closed from 8am to 10am on Thursday 19 December for servicing. We apologise for any inconvenience.
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    GELSS Membership Agreement Form

    Responsible person details
    Secondary responsible person details (optional)

    Note: this person has been given permission by the parent to access information regarding my child/ren’s swimming membership at Glen Eira Leisure. This information is limited to lesson time and changes, level information, membership  payment/billing information, suspension and cancelation requests of membership. They will not automatically receive communications related to the student's membership.

    Student 1 Details
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    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

    Student 2 Details
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    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

    Student 3 Details
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    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

    Student 4 Details
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    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

    Student 5 Details
    Information
    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

    Student 6 Details
    Information
    Date cannot be more than 7 days in advance of date of form submission.

    Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

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    Privacy: The personal information requested is required primarily for the provision of the selected membership service and will only be shared with those directly responsible for providing that service. If you do not provide the information, we may not be able to deliver the service. If you would like to know more about privacy at Glen Eira City Council, including your right to seek access to any information collected on this form, please visit our Privacy page or contact Council’s privacy officer on 9524 3333.

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