MEMBERSHIP APPLICATION

Membership single $20.00 (PLEASE fill out registration and submit too)

Membership family $35.00 (PLEASE fill out registration and submit too)

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ONLY THREE STEPS AWAY!!! ...P-L-E-A-S-E... Scroll... down... (Two steps if you pay by Pay Pal) ...USE FOR RENEWALS TOO :)... IF your personal information has not changed JUST SKIP that part and go directly to Pay Pal :)

1 - Read prerequisite

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2 - Complete application AND submit

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OR MAIL

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Cheryl Ward

Make Check to: POTSPHC

4536 SW CR 18

FORT WHITE, FL 32038

STEP # 1 - PREREQUISITE

STEP # 2

DUES:
$20.00 SINGLE
$35.00 COUPLE/FAMILY
* (INCLUDES ONE NAME BADGE PER MEMBER)
* EXTRA BADGES: $5.00 PER PERSON
* KEET'S UNDER 17 FLY FREE
* ALL RENEWALS ARE DUE FEBRUARY 1ST (OF EACH YEAR)
* " This contribution is not deductible as a charitable contribution for Federal income tax purposes."

I WOULD LIKE TO BE INVOLVED WITH:

LEADER POSITION

NEWSLETTER

COMMUNITY SERVICE

PLANNING EVENTS & TRIPS

CLUB PROMOTIONS

CONCERTS

WEEKEND TRIPS

HOSTING PARTIES

BY SIGNING THIS MEMBERSHIP FORM, I ACKNOWLEDGE THAT I AM RESPONSIBLE FOR MY BEHAVIOR (AND CHILD'S BEHAVIOR, IF APPLICABLE) AND THAT IN NO WAY HOLD "GATORS IN PARADISE PHC" OR, ANY OF THEIR OFFICERS LIABLE FOR MY ACTIONS OR INJURIES AT ANY EVENT, I SHALL TREAT MEMBERS, GUEST AND HOST AND THEIR PROPERTY, WITH RESPECT...SINCE, PARROT HEADS ARE KNOWN TO ENJOY A COLD ONE...WE SUGGEST USING A DESIGNATED DRIVER.

STEP # 3

DON'T FORGET TO MAIL YOUR CHECK OR PAY VIA PAY PAL

WELCOME TO THE PHLOCK :)