SBPHC Membership Form (single payment revision)

MonthDayYear

Membership ($30)*

NewRenewal

Renewal membership year runs from March 1 to February 28 (29) of the following year.

If new membership registration occurs after November 1st, your initial membership year will run to March 1 of the following year.

Yearly Dues:

PLEASE NOTE: Actual payment amount has been updated to reflect a processing fee of 3.5% and a 10 cent service charge (courtesy of Chase bank).

Membership Dues

PLEASE NOTE: Actual payment amount has been updated to reflect a processing fee of 3.5% and a 10 cent service charge (courtesy of Chase Bank).

Name*

First NameLast Name

E-mail*

Confirmation Email

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.

reuse existing membership data

noyes

Birthday (month and day are required, year is N/A)

MonthDayYear

Cell Phone*

Area CodePhone Number

Home/Work Phone

Area CodePhone Number

Alias/Nickname

Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

The following selected options infers your consent to be included in the clubs directory and members only section of the clubs website.*

NamePhoneEmail

How did you hear about us?

Favorite Buffett Song:

Favorite Buffett Lyric:

My One Particular Harbor is:

I like mine with...

What kinds of events would you like to volunteer for:

Anything we forgot:

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 Sarasota Bay 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. Activities organized by the club are for enjoyment of the membership of the Sarasota Bay Parrot Head Club. 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. Sarasota Bay 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):*

Our Meetings are at 6:30 pm every 2nd Thursday of the month:

Fin & Tonic

6747 S Tamiami Trail

Sarasota, FL 34231

Enter the message as it's shown*

My Products

membership$30.00

2025 membership dues

Subtotal $0.00Tax $0.00Shipping $0.00Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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If Payment is not completed, application will not be submitted

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On-line Membership Application

PLEASE NOTE: Actual payment amount has been updated to reflect a processing fee of 3.5% and a 10 cent service charge (courtesy of Chase bank).