Curzon card application form 2

CURZON CRAWLEY Unlimited Cinema Pass

Your Details

Membership Details

Mr | Mrs | Miss | Ms | Dr

Monthly Direct Debit amount

Fore Name(s)

First Payment Received

Surname

Date of first Direct Debit

Address

Hawth Account Number Reference: HAWTH

Postcode

I have read and agree the conditions of use as detailed overleaf

Home Telephone Mobile Number

Signed

Email Address

Date

Please complete the form and return to:

Instruction to your Bank or Building Society to pay Direct Debit

Name and address of your bank/building society

Service User Number

Parkwood Leisure, Attwood House, Perdiswell Park, Droitwich Road, Worcester WR3 7NW

To

4

Address

Postcode

Account Number

9

4

4

1

Reference

H

Name of Account Holder

2

A

W

T

H

Instruction to your Bank or Building Society Please pay Parkwood Community Leisure Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee.

I understand that this instruction may remain with Parkwood Community Leisure Limited and, if so, details will be passed electronically to my Bank/Building Society.

Signature

Sort Code

Date

Banks and Building Societies may not accept Direct Debit instructions for some types of accounts

Welcome to your Curzon Crawley membership Your Curzon Card entitles the named holder to free unlimited access to Curzon film screenings at The Hawth Crawley. The card does not entitle the holder entry to any special or private screenings or any live events in The Studio (although you may be offered discounts to other events as an added benefit of membership).

Conditions of Use 1. Membership is offered for a minimum of 12 months. Members can pay either by annual subscription in advance or monthly by direct debit. Members paying annually in advance save 10%.

2. The Direct Debit contract will commence on the date stated on the front of this form under ‘Date of first Direct Debit’. If you wish to terminate your membership agreement during the first 12 months you must do so in writing to Parkwood Leisure. Terminations will be calculated from the ‘Date of first Direct Debit’ where a single cancellation fee equivalent to 2 monthly payments will be required.

3. Direct debit payments will continue beyond 12 months until such time as you advise us in writing of your intention to cancel. Please notify us at least 14 days before your Direct Debit due date in writing to The Hawth, Hawth Avenue, Crawley RH10 6YZ. Members are advised to take steps to cancel their direct debit thereafter and are required to return their card.

4. During your first 12 months, you can transfer your direct debit membership to a friend or relative who can then take over the remainder of your existing membership term. In this instance your cancellation fee would be waived. A nominal administration charge for the transfer will be made to the new member. Annual memberships are non-refundable but may be transferred.

5. All members are required to show their membership card at Box Office when booking or collecting tickets.

Membership cards are non-transferable and must only be used by the registered cardholder. The benefits and tickets obtained through the membership must not in any circumstances to transferred or sold to any third party. Normal conditions of entry apply.

6. We will write to inform you a minimum of 10 working days in advance before the introduction of any price increase or change in terms and conditions. Please inform us of changes to your personal details such as address, telephone number, email address so that these communications may be made.

7. In order to keep members up to date with promotions and support services, Parkwood Theatres will email customers bulletins on an ad hoc basis. Member’s email addresses will not be shared with third parties.

The Direct Debit Guarantee • This Guarantee is offered by all banks and buildings societies that accept instructions to pay Direct Debit.

• If there any changes to the amount, date or frequency of your Direct Debit we will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Parkwood Community Leisure to collect a payment, confirmation of the amount and date will be given to you at the time of the request.

• If an error is made in the payment of your Direct Debit, by Parkwood Community Leisure or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society – if you receive a refund you are not entitled to, you must pay it back when Parkwood Community Leisure asks you to.

• You can cancel a direct debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.