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Membership Form
Name: ______________________________________________________
Address:_____________________________________________________
City:__________________ State:________________ Zip:_____________
Home Phone:____________________ Work Phone:___________________
E-Mail:_____________________________ Fax:_____________________
Birthday:_______________________ T-Shirt Size: S / M / L / XL / XX / XXX
I am interested in the following activities:
___Parties ___Hosting Parties
___Writing for Newsletter ___Producing Newsletter
___Local Community Service ___Natl. Community Service
___Concerts ___Weekend Trips
___Scuba Diving ___ Deep Sea Fishing
___Camping ___Club Promotion
How did you hear about the club? ____________________________________
Is it OK to print the following information in the club newsletter?
Name (Yes /No)
Address (Yes/No)
Phone (Yes/No)
Comments/Helpful hints: _________________________________________
_____________________________________________________________
The Obligatory Fine Print
Each member of the Magic City Parrot Head Club is responsible for his or her own actions and behavior, whether positive or negative. Membership in the club does not give the member permission to use Jimmy Buffett's name, song titles, lyrics, names of businesses or other trademarked, copyrighted or reserved material owned by Jimmy Buffett. Nor may any member use the logo of the Magic City Parrot Head Club or Parrot Heads in Paradise, Inc.
Since Parrot Heads are known to enjoy a cool one or two, we support using a designated driver.
Your Membership dues are not deductible as a charitable contribution for income tax purposes.
