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Select Renewal Type
 
Membership Type:
 
Please Update Your Information Where Applicable
 
*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip Code:
*Phone:
*E-Mail:
 
Please Update Your Significant Other Information Where Applicable (Family Memberships Only)
 
Significant Other (living in same household)
 
SO First Name:
SO Last Name:
SO E-Mail:
 
Please Update Your Keet Information Where Applicable (Family Memberships Only)
 
Must be under 18 years of age and a dependent. Otherwise please add as a separate single membership.
 
Keet 1 Name:
Keet 2 Name:
Keet 3 Name:
Keet 4 Name:
 
GRAND TOTAL:
 
PHounding PHeather
 
Phounding Pheather Membership Type:
 
IMPORTANT: Phounding Pheather Memberships are only available to individuals who have been designated as such per PHCF`s bylaws in Article IV 1.5. DO NOT select this option unless you are one of these named individuals!
 
Agreement and Release of Liability
 
(1) In consideration of being allowed to become a member of the Parrot Heads of Central Florida (“PHCF”) and to attend, work at, and/or participate in any and all activities, events, functions, and/or other occasions that PHCF has planned, sponsored, chaired, and/or otherwise supported, both before and at any time after I have become a member, I do hereby waive, release and forever discharge PHCF and its officers, agents, employees, representatives, executors, members, and all others, from any and all responsibilities or liabilities from injuries or damages arising out of, or connected with, my/my family’s membership in PHCF, my/my family’s participation in all activities, my/my family’s use of any equipment owned or utilized by PHCF, or any act or omission, including negligence by any representative or other member of PHCF.

(2) If I am joining PHCF with my spouse, my children, and/or any other family members or significant others, I understand that this Agreement and Release of Liability fully applies to each and every person who is joining PHCF under my membership. If, at a later date, any person or persons join PHCF under my membership, I understand that I will be required to sign and initial a new Agreement and Release of Liability.

I confirm that I have read and fully understand both paragraphs (1) and (2) above. I further confirm that if I did not fully understand both paragraphs (1) and (2), I requested and I received satisfactory clarification from one of PHCF’s officers, before submitting this form electronically.
 
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