You are about to create a Direct Debit Request for Buggy Bootcamp

Customer Details

Please enter your details, including the reference number given to you

Debit Arrangement

Please enter your regular debit arrangement

Regular Debits

One Time Setup Fee

$5.50

Bank Account

$1.25

Optional SMS Reminder

$0.00

Visa/Mastercard

2.5% (min $1.25)

Amex/Diners

4.4% (min $1.25)

Failed Payment Fee

$21.90

Payment Method

Please choose a method of payment

Payments will appear on your statement as BUGGY BOOTCAMP

I / We authorise Global Payments Australia 1 Pty Ltd ACN 601 396 543 (User ID No 342190, 342191, 428198) to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance with this Direct Debit Request.

Service Agreement

*This is a preview page only, no payments can be taken on this page.