MEMBERSHIP
PARROTS OF THE
Name:________________________________________________
Spouse_________________________
Address:______________________________________________________________________________
City, State,
Zip:_________________________________________________________________________
Home
Phone:_________________________________Cell
Phone:________________________________
E-Mail
Address:________________________________________________________________________
Is it OK to print your
name/address/phone/email?___________ Birthday(s)___________/______________
Occupation_________________________________Hobbies____________________________________
If you have a business, we would like to
list you as a preferred parrothead business owner? Is this ok?____
Business Name and
Info_________________________________________________________________
_____________________________________________________________________________________
How did you hear about the
club?__________________________________________________________
Annual dues are $20.00 for individuals and
$30.00 for married couples.
Please make checks payable to: NWIPHC, 185
W. 150 N.,
The
Northwest Indiana Parrot Head Club/Parrots of the
Parrot Heads in Paradise, Inc., a national organization
recognized by Jimmy Buffet.
THE OBLIGATORY FINE PRINT
*Each member is responsible for their own actions and
behavior whether negative or positive.
*Membership in the club does not give the member
permission to use Jimmy Buffett’s name, song titles, lyrics, names of
businesses or other trade marks, copyrights or reserved material owned by Jimmy
Buffet nor can any member use the logo of the NWIPHC/Parrots of the Caribbean
or Parrot Heads in Paradise, Inc.
*Since Parrot Heads are known to enjoy a cold one, we
heartily support using a designated driver.
Note: Annual Dues are not deductible as a charitable
contribution for federal income tax purposed.