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Membership applications can either be completed using the Paper Membership Application and paid for using Venmo, cash or check or the Online Membership Application and paid for using a credit card or check.

Paper Membership Application

Online Membership Application

"*" indicates required fields

New Membership or Renewal?*

New Membership – $25 each for 2025

Renewal – $25 each for 2025

Quantity

Select the number of Members (same household)

Member Name*

First Last

Nickname for badge (optional)

Member Birthday

Member Email

Please note: E-Mail is the main form of communication

Member Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

I’m interested in learning more about assisting with:

Supporting a charity that I’m connected to: (optional)

Other (Full Moon Bonfires, Happy Hours, etc.):

Beach Bash (optional)

Collecting silent auction baskets/items

Assisting with activities/games/food

Talents/resources/connections that I can offer: (optional)

Email is the primary mode of communication. Please assure that you are able to receive emails from padreislandphcofcc@gmail.com. Completed applications and dues can be submitted in person (Venmo, cash or check) or mail check to Padre Island Parrot Head Club of CC, PO Box 18021 Corpus Christi, TX 78480, or visit www.padreislandparrotheads.com to pay electronically, fees apply.

Permission for my information to be included on a roster to be shared with other club members.*

I DO give permission for my information to be included on a roster to be shared with other club members.

I DO NOT give permission for my information to be included on a roster to be shared with other club members.

Consent*

I agree to the following:

PIPHC-CC is a sanctioned club of Parrot Heads in Paradise (PHIP). Membership in this club does not give
permission to use Jimmy Buffett’s name, song titles, lyrics, names of business or other trademarked, copyright, or
reserved material owned by Jimmy Buffett; nor can any member use the logo of PIPHC-CC or PHIP without
permission. PIPHC-CC is not responsible for members’ actions/behaviors and members shall treat members,
guests, hosts, and their property with respect. Members agree to abide by all local, state, and federal laws, and all
bylaws of the PIPHC-CC. Donations and membership dues are not deductible as a charitable contribution for tax
purposes.

2nd Member Name*

First Last

2nd Member Nickname for badge (optional)

2nd Member Birthday

2nd Member Email

Please note: E-Mail is the main form of communication

2nd Member Phone

I’m interested in learning more about assisting with:

Supporting a charity that I’m connected to: (optional)

(2nd member)

Other (Full Moon Bonfires, Happy Hours, etc.):

(2nd member)

Beach Bash (optional)

Collecting silent auction baskets/items

Assisting with activities/games/food

(2nd member)

Talents/resources/connections that I can offer: (optional)

(2nd member)

Permission for my information to be included on a roster to be shared with other club members.*

I DO give permission for my information to be included on a roster to be shared with other club members.

I DO NOT give permission for my information to be included on a roster to be shared with other club members.

(2nd member)

Consent*

I agree to the following:

Doug Wells on 1st Annual Padre Island Parrot Heads of CC Chili Cookoff and Club Happy Hour

Membership applications can either be completed using the Paper Membership Application and paid for using Venmo, cash or check or the Online Membership Application and paid for using a credit card or check.

Paper Membership Application

Online Membership Application

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