Direct Debit Request (DDR)


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  • A. $9.95 SILVER Membership

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    • Use of over 100 other gyms throughout New Zealand
    • Complimentary consult and individualised program with a personal trainer (value $60)
    • Free Car Parking (over 140 carparks)
    • FREE Reassessments

    Special Conditions

    • 12mth Minimum Term
    • $49 one-off admin fee
    • $25 club improvement fee (1st of October each year) Goes toward new equipment and gym upgrades every year
    • Ability to place membership on hold for any reason (1week-1month/year)
    • $20 for 24hr access card (optional), complimentary card for staffed hours (Mon to thurs 5.30am till 8pm Friday 5.30am till 7pm and Sat 9-2)

First Payment Date & Frequency


Payment Details

Please make sure all fields highlighted in red have been completed and are correct

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Customer Details


Additional Details

Address Details


Contact Details

Direct Debit Payment Options


Direct Debit From Bank Account, Building Society or Credit Union


I/We authorise Debitsuccess Pty Ltd ACN 095 551 581, APCA User ID Number 184534 to debit my/our account at the Financial Institution identified here through the Bulk Electronic Clearing System (BECS)
(Not to operate as an assignment or agreement)
Authorisation Code: 0302448

Direct Debit From Credit Card

Terms and Conditions



  • Lump Sum memberships are not transferable to a second party and are not refundable.
  • Memberships may be put on hold for 1 week to 1 month – conditions apply
  • The gym will be staffed 5:45am-8pm Monday to Thursday, Friday 5:45am – 7pm, Saturday 9am – 4pm and Sunday 9am – 2pm

Outside of these hours, members are to use proximity card and enter through the rear blue door and will have access to the cardio room and heavy weights area.

  • Members are to sign a pre exercise health questionnaire after joining or upgrading.
  • The following facilities not included in your membership – toilets and showers after daytime hours, towel hire, Sauna, Sun bed, Personal Training, Supplements.
  • As part of your 24 hour membership, members will have access to the whole facility during normal opening hours and after hours will have 24 hour access to the cardio room and the heavy weights area.
  • 24 hour surveillance will be operating and monitored by staff and also a security company.
  • A panic button is placed beside the light switches in the cardio room should you need it, Just push the button and it will go through to 111, ask for police, fire or ambulance.
  • Replacement proximity cards will incur a $16 fee if lost or stolen and daytime cards $4.
  • Children under the age of 14 are not permitted into the gym unless they are a member and accompanied by a caregiver 18 years or older.
  • First Place Fitness reserves the right to refuse entry into the complex for whatever reason and cannot be held responsible for any loss, damage or injury to anybody caused whilst on the premises.
  • Always use a towel and place on machines before use or wipe machines down after use.
  • Wear correct clothing and covered shoes.
  • No eating in the gym.
  • No gang attire will be tolerated and no hoodies.
  • No abusive, obscene language or intimidation will be tolerated.
  • Any Theft, using someone else’s card or letting someone else in who doesn’t have a card will be dealt with by the police for trespassing, the member will be fined $500 and access denied.
  • Cards are property of First Place Fitness and must be returned immediately if your membership is terminated or cancelled.
  • Always be safe – To help your workouts remain positive, take simple precautions, leave your  valuables at home, work or locked in the boot of your car out of plain view.
  • You must provide a drivers license or photo ID and get a photo taken by First Place Fitness before using the facility. Cards must be picked up during staffed hours.
  • No Solicitation, First Place Fitness is provided for the public use of club members only and is not open to the public after staffed hours.
  • You can also bring friends in to be shown around during staffed hours too. (Week free cards only apply during daytime hours)
  • No alcohol, drugs, intoxicated person or any under the influence of drugs including steroids will be allowed into First Place Fitness.
  • Members are encouraged to let Management know of any suspicious behaviour and never hesitate to ring Tony or Ryan (cards beside panic button and on front door).
  • First Place Fitness reserves the right to restrict the use of equipment outside.

The Debit Success Contract – Terms and Conditions.

1.    Introduction

This document outlines the rights and responsibilities you have with regard to the ability of Debitsuccess to directly debit your nominated bank account or credit card for any instalments or payments due by you under the terms and conditions of this Contract and DDR Service Agreement, the terms of which are stated below. Should you have any queries regarding your Contract or this DDR form you should in the first instance contact Debitsuccess on 08004810400. All queries regarding the provision of services by the facility should be directed to the facility.

2.    Parties to Contract

The “Facility” means the organisation providing the service for which the Customer is paying. The ‘Customer” means the person or party signing this contract. “Debitsuccess” is Debitsuccess Limited, PO Box 34-770, Birkenhead, North Shore City, 0746.

 Phone 09 4810400, Fax 09 480 1401, e-mail: All communication relating to this contract is to be sent directly to Debitsuccess. The Customer acknowledges that Debitsuccess has been contracted by the facility to collect the instalments due under this contract, and for the purposes of the Contracts (Privity) Act 1982 the customer acknowledges that all rights of the Facility pursuant to this contract are able to be enforced by Debitsuccess as if it were the facility without any involvement on the part of the Facility or the consent of the Customer.

3.    Payments

The customer agrees to pay the instalment amount at the agreed payment frequency until this contract is terminated in accordance with clause 4.The Customer may alter the payment frequency and/or day to debit by requesting the change with Debitsuccess. Any changes shall not however affect the total amount of money the Customer would otherwise have paid for the minimum term of this contract. Should there be any arrears in payments the Customer authorises Debitsuccess to debit the outstanding balance in order to bring the account up to date. Should payments fall on a designated public holiday or a weekend day, payments will default to be collected on the next business banking day after this date.

4.    Termination of Contract

The Customer may terminate this contract before the expiry of the minimum term if all the instalments and payments due up to the time of the request have been paid in full and in addition the cancellation fee as stated on the front of this contract is paid to DebitSuccess. If the Cancellation fee has been left blank or has been crossed out then this contract may not be cancelled before the expiry of the minimum term. The contract may not be terminated before the minimum term if all payments are not paid. After the expiry of the minimum term and after all instalments and payments due have been paid in full, should the box on the front of this contract requesting termination at minimum term be marked then this contract shall automatically terminate. Should the box on the front of this contract not be marked then this contract shall continue indefinitely until such time as the Customer requests DebitSuccess, after the expiry of the minimum term for it to terminate. There will be a period of notice to terminate required of 30 days unless otherwise specified by the facility between the date of the request and the date of actual termination during which any payments that fall due must still be paid in full. Any instalments/payments due at the date of termination (including instalments/payments which fall due during the notice period) will remain a debt owed to and recoverable by Debitsuccess The Customer shall not consider that this contract has been terminated until such time as this is confirmed in writing to the Customer by Debitsuccess to the last advised address provided by the Customer. Termination of this contract will also terminate the Direct Debit Request Authority.

5.    Late Payment Fee

A late payment fee of $10.00 is payable by the Customer to Debitsuccess for each reversal of a payment initiated by DebitSuccess in accordance with the terms and conditions of this Contract.

6.    Administration Fee

A one-off fee of $35.00 is payable to Debitsuccess by the Customer on signing of this Contract. This will be added to the first instalment being paid by the Customer as a separate payment.

7.    Privacy

The Customer authorises the Facility or Debitsuccess to contact the customer for any purpose. The customer has the right under the Privacy Act 1993 to obtain access to and request correction to any personal information concerning the customer held by the facility or Debitsuccess. If you tick the box on the front of the contract that states “If you wish to receive special product and service offerings from us please tick the box” you acknowledge that personal information collected or held by the facility or DebitSuccess may be used by third parties approved by the facility or Debitsuccess to make offers to you.

8.    Liability

To the extent permitted by law, the Facility and Debitsuccess shall not be liable or responsible to the customer for any indirect or consequential injury, loss or damage to the customer or the property of the customer whatsoever and howsoever arising. Nothing in this clause is intended to have the effect of contracting out of the Consumer Guarantees Act 1993 except to the extent permitted by the Act.

9.    Debt Collection Action

The customer authorises Debitsuccess to notify any debt collection/credit reporting agency upon default by the customer in regard to any obligation under this contract. Should this occur the full outstanding balance of the remainder of the minimum term including any current arrears shall be immediately due in full. In addition, Debitsuccess shall add $50 to the outstanding debt as its fee for dealing with the defaulting customer. The Customer agrees to pay any and all costs incurred as a result of debt collection including the commission charged by the debt collection agency (approx 25% of the outstanding debt as previously calculated).

10.  Entitlement

The Customer acknowledges that the Facility may make reasonable changes to the service it provides, to the extent that such changes do not materially disadvantage the Customer. The Debitsuccess Contract is based on “entitlement” to use and not on "actual" use of the services. He/She agrees to be bound by the rules and conditions of the Facility and that the Facility and/or Debitsuccess may remove the Customer's entitlement of use of the services "with good cause". For avoidance of doubt, this includes where: the Customer fails to comply with the Rules of Use of the Facility so as to interfere with use and/or enjoyment of the Facility by other customers; and where the Customer fails to make any payment due, by its due date.


11.  Provision of Service

Reasonable change of location of not more than 4 km, or change of ownership or the name of the Facility does not absolve the customer of the responsibility under this contract.

12.       Increase in Instalment Amount The Facility and Debitsuccess may at any time after the expiry of the minimum term, upon sending written or electronic notice to the Customer’s last known address at least 30 days prior to the increase, increase the instalment amount.

13           Fitpass

FITPASSES are not valid in the same town or city where membership is held. The issuing and acceptance of FITPASSES is at the sole discretion of Debitsuccess or the Facility. Debitsuccess takes no responsibility should any Facility refuse to accept a FITPASS or attempt to charge the customer for the use of a FITPASS. Any FITPASS issue shall not absolve the customer from any payment obligations under this Contract.

14        Entire Agreement

This contract, the DDR service agreement and any Membership Agreement entered into between the Customer and the Facility (the “Facility membership Agreement”) constitutes the entire agreement, understanding and arrangement (express and implied) between the Customer, the Facility and Debitsuccess relating to the subject matter of this Contract and supersedes and cancels any previous agreement, understanding and arrangement relating thereto whether written or oral. In the event of any inconsistency between the term(s) of this contract, the DDR Service agreement and the Facility Membership Agreement (where such inconsistent term(s) specifically relate to the rights and obligations of the facility, other than the right to unilaterally vary fees payable), the term(s) of the Facility Management Agreement (which specifically relate to the rights and obligations of the Facility) will prevail only to the extent of such inconsistency. If any provision of this contract is invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions will not be affected and such invalid, illegal or unenforceable provision is to be severed from this Contract.

15 Statement of Right to Cancel

The Credit Contracts and Consumer Finance Act 2003 gives a right for a short time after the terms of this contract have been disclosed to you to cancel the contract.

How to cancel

If you want to cancel this contract you must give written notice to the creditor.

You must also:

Return to the creditor any advance and any other property received by you under the contract (but you cannot do this if you have taken possession of any goods or if you bought any property at an auction or if the contract is for the sale of services that have been performed); or

Pay the cash price of the property or services within 15 working days of the day you give notice.

Time limits for cancellation

If the disclosure documents are handed to you directly you must give notice that you intend to cancel within 3 working days after you receive the documents.

If the disclosure documents are sent to you by electronic means (for example, email) you must give notice that you intend to cancel within 5 working days after the electronic communication is sent.

If the documents are mailed to you, you must give the notice within 7 working days after they were posted.  Saturdays, Sundays and national public holidays are not counted as working days.

What you may have to pay if you cancel

If you cancel the contract the creditor can charge you:

a)  The amount of any reasonable expenses the creditor had to pay in connection with the contract and its cancellation (including legal fees and fees for credit reports, etc); and

Interest for the period from the day you received the property or services until the day you either pay the cash price for the property or services or return the property to the creditor.

This statement only contains a summary of your rights and obligations in connection with the right to cancel.  If there is anything about your rights or obligations under the Credit Contracts and Consumer Finance Act 2003 that you do not understand, if there is a dispute about your rights, or if you think that the creditor is being unreasonable in anyway, you should seek legal advice immediately.

I acknowledge that I have read and accepted the terms of the contract and have been given a copy of this contract.


Terms and Conditions of this Instruction to accept Direct Debits


1. The Initiator:

a. Has agreed to give written advance notice to the Acceptor of the net amount of each Direct Debit and the due date of the debiting at least 10 calendar days before (but not more than 2 calendar months) the date when the Direct Debit will be initiated. This advance notice will include the following message:- "Unless advice to the contrary is received from you by (date*), the amount of $...............will be directly debited from your bank account on (initiating date)."

* this date will be at least two (2) days prior to the initiating date to allow for amendment of Direct Debits.

b. May, upon the relationship which gave rise to this Instruction being terminated, give notice to the Bank that no further Direct Debits are to be initiated under the Instruction. Upon receipt of such notice the Bank may terminate this Instruction as to future payments by notice in writing to me/us.

2. The Customer may:

a. At any time, terminate this Instruction as to future payments by giving notice of termination to the bank and to the Initiator.

b. Stop payment of any Direct Debit to be initiated under this Instruction by the initiator by giving written notice to the Bank prior to the Direct Debit being paid by the Bank.

c. Request the Bank to reverse any Direct Debits initiated by the Initiator under the Instructions by debiting the amount of the Direct Debits back to the Initiator through the Initiator's Bank where the Initiator cannot produce a copy of the Instructions and/or Confirmation to me/us that I/we are reasonably satisfied demonstrate that I/we have authorised my/our bank to accept Direct Debits from the Initiator against my/our account PROVIDED the request is made not more than 9 months from the date when the first Direct Debit was debited to my/our account by the Initiator under the Instructions.

3. The Customer acknowledges that:

a. This Instruction will remain in full force and effect in respect of all Direct Debits passed to my/our account in good faith notwithstanding my/our death, bankruptcy or other revocation of this Instruction until actual notice of such an event is received by the Bank.

b. In any event this Instruction is subject to any arrangement now or hereafter existing between me/us and the Bank in relation to my/our account.

c. Where a variation to the amount agreed between the initiator and the Customer from time to time to be Direct Debited has been made without notice being given in terms of 1(a) above, request the Bank to reverse or alter any such Direct Debit initiated by the initiator by debiting the amount of the reversal or alteration of the Direct Debit back to the intiator through the Initiator's Bank, PROVIDED such request is made not more than 9 months from the date when the Direct Debit was debited to my/our account.

d. The bank accepts no responsibility or liability for the accuracy of information about Direct Debits on Bank Statements.

e. The Bank is not responsible for, or under any liability in respect of:-

  • any variations between notices give by the initiator and the amounts of Direct Debits.
  • the Initiators failure to give written advance notice correctly nor for the non receipt of late receipt of notice by me/us for any reason whatsoever. In any such situation the dispute lies between me/us and the Initiator.

4. The Bank may:

a. In its absolute discretion conclusively determine the order of priority payment by it of any monies pursuant to this or any other instruction, cheque or draft properly executed by me/us or given to or drawn on the Bank.

b. At any time terminate this Instruction as to future payments by notice in writing to me/us.

c. Charge its current fees for this service in force from time-to-time.

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I Agree

Final Declaration

You warrant, declare and acknowledge that:
1. The information given by you in entering this Direct Debit Request And Customer Contract is correct and will be relied upon by us.
2. You have read this agreement, including the Terms and Conditions and Product Disclosure Statement before accepting them below.
3. This agreement will become binding upon all parties once you have ticked in the "I agree" box below and the "Submit Form" button has been clicked.
I Agree

Compare Membership

Minimum Payment Period 12 months
Weekly Payments of $9.95
First payment date 27-Feb-2018
Total first payment $58.95
  • Use of over 100 other gyms throughout New Zealand
  • Complimentary consult and individualised program with a personal trainer (value $60)
  • Free Car Parking (over 140 carparks)
  • FREE Reassessments

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