TRAVERSE CITY PARROT HEAD CLUB

                      PO Box 328

                        Acme, MI  49610

                 www.tcparrotheads.com

Membership Form Single $5 / Family $10

Name(s): _____________________________________________________________

Address:______________________________________________________________                   OPTIONAL

City:__________________________________State/Zip:______________________         Check here to receive

Home Phone:_______________________Work Phone:_______________________         newsletter by e-mail

E-Mail Address: _________________________Fax:___________________________                  _______

I am interested in the following activities:

__Parties__Writing for Newsletter__Producing Newsletter__Hosting Parties

__Local Community Service__National Community Service__Concerts

__Club Promotion & Marketing__Weekend Trips__Outdoor Activities

Other________________________________________________________________

Comments:___________________________________________________________

The Obligatory Fine Print:

Each member of the Traverse City Parrot Head Club is responsible for his or her own actions and behavior and shall treat phellow members, guests, hosts, and their personal property with respect. Members agree to abide by all local, state and federal laws. Members agree to abide by all the bylaws of the Traverse City Parrot Head Club.

Membership in the club does not give the members 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 can any member use the logo of the Traverse City Parrot Head Club or Parrotheads in Paradise, Inc.

Since Parrot Heads are known to enjoy a cold one, we support using a designated driver. This contribution is not tax deductible as a charitable contribution for federal or state income tax purposes.

Signature/date_________________________Signature/date_______________________

Print out and fax to 1 888 867 7910 or mail to Traverse City Parrot Head Club PO Box 328, Acme, MI  49610 or bring it to the next meeting.