Space Coast Parrot Head Club Membership Application
  • Space Coast Parrot Head Club Membership Application

    Space Coast Parrot Head Club Membership Application

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    Party with a Purpose

    SCPHC Membership Form

    The Space Coast Parrot Head Club is a NOT FOR PROFIT organization, 501(c)(3), to promote friendships and organize social activities for people with similar interests including enjoymet of the tropical spirit of Jimmy Buffett's music.

    We encourage our members to participate in a variety of volunteer efforts in the local, regional and national community for social and enviromental causes. The club is fully chartered and officially recognized by Parrot Heads in Paradise, Inc. (PHIP). PHIP is the organization for oversight of all local Parrothead Clubs worldwide.

    Membership Fees

    New Membership

    $30 per person (plus $2 if applying online)

    “This contribution is not deductible as a charitable contribution for Federal income tax purposes.”

    If you wish to download and fill out form for mailing, click HERE

    Payments are processed through Paypal. A Paypal account is not required.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Space Coast Parrot Head Club Code of Conduct & Agreement


    As a “Space Coast Parrot Head” (SCPH), you will be issued a name tag (hangie thingie) to be worn at all club functions. It is the intention of the Space Coast Parrot Head Club (SCPHC) to provide social and charitable activities for the enjoyment and
    benefit of all our members, guests and benefiting organizations. The SCPHC seeks to provide a pleasant atmosphere in which to share our common love of the music and tales of Jimmy Buffett and to further the charitable ideals we seek to uphold.


    All SCPHC members agree to treat all SCPHC members, members of the Parrot Heads in Paradise (PHIP, Inc.), all other Parrot Head Club members, their guests, any benefiting organizations, and their personal property with respect. SCPHC
    members agree to abide by all local, state and federal laws governing (including but not limited to): misuse of personal privileges, personal property, and controlled substances. SCPHC members agree to demonstrate personal responsibility for
    their words, actions and deeds. SCPHC members agree not to exhibit behaviors that are harmful to themselves or others or to harm anyone’s property.


    As a SCPHC member, I hereby agree for myself, my heirs and personal representatives to assume any and all risks associated with any SCPHC or PHIP, Inc. event that I attend and further waive, release, discharge and covenant not to sue
    the SCPHC or PHIP, Inc. , their officers, members, sponsors, or other representatives or successors and assigns for any injuries or damage of any kind whatsoever, as a result of taking part in an event and related activities sponsored by these parties.

    I have read, understand and agree to the above code of conduct and release. 

  • Signature Date*
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  • Signature Date
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  • My Products

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    SCPHC Membership. New Members $30.00 per person plus $2.00 for online application
    SCPHC Membership

    New Members $30.00 per person plus $2.00 for online application

    $32.00$32.00

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