Tuscaloosa Area Parrot Head Club
Membership Form

___ Place an "X" here if this is a renewal

Name: ___________________________________________
Address:____________________________________
City:_____________________________ State:_________ Zip:_________________
Home Phone:_______________________ Work Phone:_______________________
E-Mail Address:____________________________________
Birthday:_________________________

I am interested in assisting with the following activities
(check as many as apply):
____ Writing/Publishing Newsletter ____ Event Location Hunting
____ Phone Committee ____ Various Concerts
____ Trips ____ Soliciting Merchant Support
____ Community Outreach/Volunteering ____ Event Planning

The Obligatory Fine Print

Each member of the Tuscaloosa Area 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 Tuscaloosa Area 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***
Please make checks payable to: Tuscaloosa Area Parrot Head Club
Mail to:
Tuscaloosa Area Parrot Head Club
15 Guilds Wood
Tuscaloosa, Alabama 35401