Virtual Parrot Head Club Registration Form

2023 Virtual PHC Membership Application

To apply for membership please complete all questions*
MonthDayYear
If you have any questions about your dues, please email:
- Suzanne Calhoun: suzcalhoun@gmail.com
Dues are $20 per person until March 1st.

Beginning March 1st, VPHC Dues will be $30 per person.
Name*

First NameLast Name
Alias/Nickname
Birthday

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation Email
Cell Phone

Area CodePhone Number
New members will receive an invitation email to join our Google E-mail Group (this is our primary source of communication!). Instructions for joining will be contained in the email.
Completion of this application and payment of dues is your consent to membership in this organization. As member you agree to bylaws adopted by the membership of the Virtual Parrot Head Club as well as Parrot Heads In Paradise, Inc., and the use of the above information by the club for matters pertaining to its operation and events. Our officers or members are not liable for any injury, loss or damage of personal property. Each member is responsible for his or her own behavior as well as that of their children. Virtual Parrot Heads, its members and its officers will not be responsible for your actions during your association with the organization. This contribution is not deductible as a charitable contribution for Federal Income Tax purposes per PHIP bylaws. The terms Jimmy Buffett, Margaritaville, Parrot Head(s), Parrothead(s), Parrot Head Club, Parrothead Club and PHC are registered trademarks of Margaritaville Inc.
Signature (initials):*
Virtual Parrot Head Club website: https://virtualphc.com/

Parrot Heads In Paradise website: https://www.phip.com/
Enter the message as it's shown*
Membership Dues
Adjusted Payment
Membership Payment

prevnext( X )
USDPLEASE NOTE: Actual payment amount has been adjusted to reflect a processing fee of 3.7% and a 49 cent service charge (courtesy of PayPal).
If you do not have a PayPal account there will be an option to enter your credit card information.
**************************************************************

If Payment is not completed, application will not be submitted

**************************************************************
Should be Empty:

2023 Virtual PHC Membership Application