Leisure Card Enrolment Form - Wellington City Council

PDWCC83818
Fold in half, seal and return
Freepost 2199
Recreation Wellington (SECC07)
Wellington City Council
PO Box 2199
Wellington 6140
Wellington City Council’s Leisure Card allows people on low incomes and people who
meet other criteria discounted entry into a range of recreation and leisure services.
You qualify for the card if you are a Wellington City resident and:
• a Community Services Card holder or
• on the Invalid’s or Sickness benefit or
• a recent migrant (within last six months) or
If you are not eligible please pass this on to someone who is.
• on the Green Prescription (GRx) scheme or
• a Wellington City Council city housing tenant or
• a SuperGold Card holder.

What you need to include
with your Leisure Card
enrolment form
1. ONE of the following:
OR
a photocopy of both sides of your
Community Services (CSC) or
SuperGold card (SGC)
Green prescription referral form
OR a recent letter from WINZ, that shows your name, address and client number.
2. Proof that you live in Wellington
Photocopy or tear the top off a bill showing your name
and address.
3. Photo
1. Send a head and shoulders photo of yourself with
your enrolment form.
OR 2. You may email your photo to leisurecard@wcc.govt.nz
Please put your name as the subject line.
OR 3. You can get your photo taken for your Leisure Card
application at these Wellington City Council facilities:
Kilbirnie Pool Reception 9–10.30am, Mon–Fri
Kilbirnie Crescent
Kilbirnie Recreation Centre 1–3pm, Mon–Fri
Kilbirnie Crescent
Freyberg Fitness Centre 10am–12noon, Mon–Fri
(upstairs at Freyberg Pool)
Karori Pool, Donald Street 10am–12noon, Mon–Fri
Tawa Pool, Davies Street 10am–12noon, Mon–Fri
Wellington City Council Reception 1–2pm, Fridays
Wakefield Street
Smart Newtown 10am–2pm, Mon–Fri
(next to Newtown Library)
Keith Spry Pool (Johnsonville) 10am–12noon, Mon–Fri
Tear here, fold in half, seal and return
Enrolment form
First name:
Surname:
Address:
Suburb: Postcode:
Phone number:
Email address:
Date of birth: Gender: M F (please circle one)
Please read and sign the following:
1. I acknowledge that personal information provided by me and held by Wellington City
Council will be used for the administration of my Leisure Card application and ongoing
use of that card.
2. I have the right under the Privacy Act 1993 to request access to and correction of my
personal information held by Wellington City Council.
3. I agree to Wellington City Council notifying me of relevant event or programme
opportunities relating to my Leisure Card membership.
Yes No
4. I agree that Wellington City Council can notify me of changes to Leisure Card
membership by email.
Yes No
I have included in this application:
a copy of CSC or SGC or Green prescription
proof of address
a photo (either attached or emailed)
Signed
Office use only
CSC# Expiry date
SGC SG-CSC Address verified