Membership Application


Magic City Parrot Head Club
Party With a Purpose
Membership Application

Name:_____________________________________________________________________________________________________________

Spouse Name:_________________________________________________________________________

Address:___________________________________________________________________________________________________________

City:_____________________________________ State:_____ Zip:________________________

Home Phone:_____________________ Cell Phone:______________________ Other:_____________________

Email:____________________________________________

Secondary Email:____________________________________________

Circle Any Informational Items you don not want shared with other club members:
Name        Address        Phone       Email

BY SIGNING THIS FORM I UNDERSTAND AND AGREE TO THE FOLLOWING:

Each Member of the Magic City Parrot Head Club is responsible for their own actions and behavior. Membership in the club does not give the member permission to user Jimmy Buffett’s name, song titles, lyrics, and business, 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. Parrot Heads like to party, so we support the use of a designated driver.

SIGNATURE_______________________________________________________________ Date:__________________

SPOUSE SIGNATURE______________________________________________________ Date:__________________

Your membership dues are not deductible as a charitable contribution for income purposes

Complete this application and return it with: $15.00 Single Membership $25.00 Couple Membership to:

JANE FRANKLIN
118 Nolen Lane
Alabaster, AL 35007

The Magic City Parrot Head Club does indeed party with a purpose. Charities served by MCPHC include Alzheimer’s of Central Alabama, Oak Mountain Ministries, Santa’s Workshop, Baptist Children’s Home, First Light, The Emergency Animal Rescue Service, Toys for Tots, Cahaba River Society, Camp ASCCA, Angel Tree of Shelby County, Shelby County Salvation Army, Children’s Hospital of Alabama, and our troops overseas.