Application for Registration

Name: Title:
Firm: Address:
City: State/Prov:
ZIP code: Telephone:
Fax: E-mail:

Preferred Name for Badge:

Media Client(s):

Please specify any special physical or dietary requirements:
Attendance at the Conference is limited to defense counsel only. The organizers reserve the right to request written confirmation from specific media client(s) of media representation.

Registration Priority (Please check all that apply)
Represent NAA Member Client
Represent NAB Member Client
Represent LDRC Supporting Organization or Defense Counsel Section Member Law Firm

Registration Fee
$645 Registration Fee
$695 Late Registration Fee (After August 14)
$445 Speaker Fee
Payment Type
I authorize the NAA to charge
American Express Mastercard VISA
Card #:
Expiration Date:
Cardholder Name:

I certify that I and the other attorneys in my firm or organization represent only media defendants and that I and the other attorneys in my firm or organization do not intend in the future to represent plaintiffs in defamation, privacy and related litigation against media defendants.

I agree.

A $200 fee may be assessed to cover costs for cancellations made on or before August 13, 2002. No refunds will be issued for cancellations received after August 14, 2002, but substitutions will be accepted without penalty.