Double up on your deal!

Please complete one form per participant, using unique email addresses for each participant.

Contact Details

Please fill in your contact details.

Firstname:*
Surname:*
Phone - Mobile:*
Email:*
Choose your area and session time:*
What date do you want to start training?*

subject to availability, your trainer will confirm your start date.

Please select your offer / promotion:*
Please enter your voucher number / promotional code:*
I aiming to attend:*
Have you trained with evolution before?*
Who referred you?
Do you agree to the rules of the game?*

Our double up offer is a one off refundable payment. It doesn't lock you in to any contract or obligation.

For a full set of the rules of the game (Ts and Cs) please click here. By answering Yes to this question you confirm that you have read, understood and agree to our terms and conditions as well as the Ezidebit Service Agreement.

Payment Details

Payment method:*
Credit Card Type:
Name on Card:
Credit Card Number:
Expiration Month:
Expiration Year:
CCV Number:
For security purposes we require additional information. Please turn over your credit card and enter the last three digits of the number printed on the back.
For AMEX cards it will the four digits on the front of the card.
Bank BSB:
Account Number:
Account Name:

Payment Terms & Conditions

Evolution to Wellbeing does not store any bank or credit card details.

This is a secure area of the site which uses Secure Socket Layer (SSL) to protect data submitted.

If you select Direct Debit - EFT as your method of payment please enter your BSB and Account Number. If you select Credit Card or skip these and enter your credit card details.

For Direct Debit: I/We authorise Ezidebit Pty Ltd ACN 096 902 813 (User ID No 165969) (“Ezidebit”) to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance with the Debit Arrangement stated above and this Direct Debit Request and as per the Ezidebit DDR Service Agreement provided.

For Credit Card: I/we authorise Ezidebit, acting on behalf of the Business, to debit payments from my specified Credit Card, and I/we acknowledge that Ezidebit will appear as the merchant on my credit card statement. Furthermore, I/we agree to reimburse and indemnify Ezidebit for any successful claims made by the Card Holder through their financial institution against Ezidebit.

Fees

  • Direct Debit - EFT - No transaction fee!
  • VISA (+1.5% (min 99c) additional transaction fee)
  • Mastercard (+1.5% (min 99c) additional transaction fee)
  • Amex (+5% (min 99c) additional transaction fee)
  • Diners (+5% (min 99c) additional transaction fee)

Pay by bank account direct deposit and we'll cover the transaction fee for you.

All transaction fees are taken directly by Ezidebit.

What our clients say
What our clients say
 

 

Meet our clients

Meet our clients

Our clients are amazing! From all walks of life, all on their own journeys, yet connected through community. Read their stories and see what they have to say.

× Close

Member Login

Email:
Password:
Forgotten your password? click here for help
× Close

Contact Us

Please select one of the following feedback forms:

Firstname:*
Surname:*
Phone - Mobile:*
Email:*
Postcode:
× Close