Kogarah Membership Suspension Request Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Mobile *Requested Start Date *Select a date4/6/2118/6/212/7/2116/7/2130/7/2113/8/2127/8/2110/9/2124/9/218/10/2122/10/215/11/2119/11/213/12/2117/12/21Requested End Date *Select a date21/5/214/6/2118/6/212/7/2116/7/2130/7/2113/8/2127/8/2110/9/2124/9/218/10/2122/10/215/11/2119/11/213/12/2117/12/21Maximum of (6) weeks suspension per calendar year. Minimum of (2) weeks of suspension per request. Suspensions are aligned with the payment schedule and are only provided to the dates above. Payments are made in advanced so please select the date 'before' you return.Declaration 1 *I acknowledge that by submitting this form it will act as a suspension request only and not confirmation of my suspension. I understand it is not complete until a Pinnacle Staff member confirms my request. Declaration 2 *I acknowledge that during this suspension period I will not access the facilities or services unless approved by a Staff member. If I wish to return sooner than expected I will inform a staff member to end my suspension. NameSubmit
