Membership Application

Contact Information

First Name *

Last Name *

Email *

Telephone *

Address Line 1 *

Address Line 2

City *

State *

Zip *

Date of Birth *

Employer information

Firm/Employer Name *

Employer Address Line 1 *

Address Line 2

City *

State *

Zip *

Experience and Qualifications

Describe your involvement in amusement/leisure industry legal affairs.

List your current bar, defense or amusement industries' trade association memberships.

How do you expect to benefit from your membership in the IALDA?

What can you contribute to the IALDA?

What percentage of your professional time do you devote to the legal affairs of the amusement and leisure industries? *

Law school and year of graduation: *

State where you are admitted to the bar and year of admission: *

States or federal jurisdictions where you and your law firm regularly practice: *

How many trials involving the amusement and leisure industry have you personally tried to a conclusion during the past five years? *

In which jurisdictions did those trials occur? *

What types of clients in the amusement industry do you regularly defend and/or represent (e.g. waterparks, roller rinks, manufacturers, suppliers, etc.)? *

Are you now representing or have you ever been retained or represented an injured claimant against a member of the amusement or leisure industry? *

If yes, please describe the case and state the name of the defendants.

Please provide a representative list of your clients in the amusement/leisure industry.

List the insurance companies, associations or corporations who know of your involvement in the industry or for whom you have worked within the past five years. Please provide the name of a contact person, their title, and an address for three contacts.

Contact 1:

Contact 2:

Contact 3:

Membership Information

Membership Status requested:
Active MemberAssociate Member

Are you willing to participate in industry events and seminars on behalf of IALDA?

If elected to membership, I agree by the by-laws and code of conduct of the IALDA and to immediately notify the IALDA of any changes in my status that would affect my qualifications as a member of this organization.

Attach your resume or biographical sketch (PDF, Word and text files accepted).

* fields are required.