Live Active

Please complete this form to allow us to reinstate your membership

If you have cancelled your payments at your bank you'll need to rejoin using this link: https://fastdd.co.uk/platinum/start.php?c=Live-Active-Leisure

Please be aware that we will manually reinstate your membership, so recommend you allow 24 hours before booking any activities to avoid being charged.

First Name(*)

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Surname(*)

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Date of Birth(*)

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Please put your Date of Birth in DD/MM/YY format.

Postcode(*)

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Email Address(*)

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Contact Number(*)

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Do you have a joint membership?

YesNo Invalid Input

Do you have an annual membership

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When is your payment date?

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Confirmation(*)

Please tick this box to confirm you have agreed to Live Active Leisure reinstating your Annual or Direct Debit membership. Invalid Input

Data Protection: The information provided by you, about you on this form, will only be used for the purposes of reinstating your membership. We are committed to complying with the General Data Protection Regulation and the Data Protection Act 2018. For further information on how we process personal data, please see our privacy policy available on our website.

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Membership Reinstatement Request