Allow Consent

I, Main Registrant’s Parent/Guardian, in consideration of Main Registrant being allowed to attend the Charity Ball for which Main Registrant is currently registering, either The 2025 County Assembly Charity Ball for high school juniors or The 2025 Red and White Charity Ball for high school seniors (the Ball for which Main Registrant is registering is hereinafter referred to as the “Charity Ball”) do hereby consent to Main Registrant’s participation in the Charity Ball and hereby represent, warrant, covenant and agree as follows:

a) I hereby assume all risk of injury and all risk of damage to, or loss of, property arising out of Main Registrant’s participation in the Charity Ball;

b) Main Registrant will refrain from consuming any alcohol, non-prescription medication or drugs or using e-cigarettes / vapes prior to, during and following said Charity Ball;

c) Main Registrant will submit to a breathalyzer test to gain entrance to said Charity Ball;

d) I understand The County Assemblies is not affiliated with the public schools, and I and Main Registrant hereby release and discharge Region 9 Board of Education, Joel Barlow High School, Fairfield Board of Education, Fairfield Ludlowe High School, Fairfield Warde High School, Weston Board of Education, Weston High School, Westport Board of Education, Staples High School, Wilton Board of Education, Wilton High School (hereafter collectively referred to as “The Schools”) and, The County Assemblies, Inc, its successors and/or assigns, it’s officers, agents, Board of Director’s, and employees (hereafter referred to as “The County Assemblies”) from any and all responsibility and/or liability (including, but not limited to, for death of Main Registrant and damage to property which may be suffered by Main Registrant) in any way relating to, or arising out of, Main Registrant’s participation in the Charity Ball, and I and Main Registrant hereby waive any and all rights and remedies I and/or Main Registrant may have now or hereafter, at law or otherwise, in any way relating to, or arising out of, Main Registrant’s participation in said Charity Ball; and

e) indemnify and hold harmless The County Assemblies and The Schools, against any and all liability, claims, demands, actions, loss, and damage in any way relating to, or arising out of, Main Registrant’s participation in said Charity Ball.

I understand The County Assemblies, Inc. is a 501 (c) (3) organization with no affiliation with the public schools. This informed consent and waiver is governed by the Laws of the State of Connecticut.

I grant permission to The County Assemblies, Inc. to (i) post photos taken during the event to the County Assemblies website, the County Assemblies Facebook page, and the County Assemblies Instagram, and (ii) receive email updates regarding this event.

I, Junior/Senior Main Registrant Parent/Guardian: Having read and understood the foregoing, and intending to be bound by the terms hereof, have executed this County Assemblies Informed Consent and Waiver, dated as of today, and my agreement to the terms and conditions contained herein by checking the box below shall for all purposes be deemed my original signature.

I, Junior/Senior Main Registrant Parent/Guardian agree to all of the terms and conditions contained herein.

I, Guest, in consideration of being allowed to attend the Charity Ball for which I am currently registering, either The 2025 County Assembly Charity Ball for high school juniors or The 2025 Red and White Charity Ball for high school seniors (the Ball for which Guest is registering is hereinafter referred to as the “Charity Ball”) do hereby represent, warrant, covenant and agree as follows:

a) I hereby assume all risk of injury and all risk of damage to, or loss of, property arising out of my participation in the Charity Ball;

b) I will refrain from consuming any alcohol, non-prescription medication or drugs or using e-cigarettes / vapes prior to, during and following said Charity Ball;

c) I will submit to a breathalyzer test to gain entrance to said Charity Ball;

d) I understand the County Assembly is not affiliated with the public schools, and I hereby release and discharge Region 9 Board of Education, Joel Barlow High School, Fairfield Board of Education, Fairfield Ludlowe High School, Fairfield Warde High School, Weston Board of Education, Weston High School, Westport Board of Education, Staples High School, Wilton Board of Education, Wilton High School (hereafter collectively referred to as “The Schools”) and, The County Assemblies, Inc, its successors and/or assigns, it’s officers, agents, Board of Director’s, and employees (hereafter referred to as “The County Assemblies”) from any and all responsibility and/or liability (including, but not limited to, for death and damage to property which may be suffered by me) in any way relating to, or arising out of, my participation in the Charity Ball, and I hereby waive any and all rights and remedies I may have now or hereafter, at law or otherwise, in any way relating to, or arising out of, my participation in said Charity Ball; and

e) indemnify and hold harmless The County Assemblies and the Schools, against any and all liability, claims, demands, actions, loss, and damage in any way relating to, or arising out of, my participation in said Charity Ball.

I understand The County Assemblies, Inc. is a 501 (c) (3) organization with no affiliation with the public schools. This informed consent and waiver is governed by the Laws of the State of Connecticut.

I grant permission to The County Assemblies, Inc. to (i) post photos taken during the event to the County Assemblies website, the County Assemblies Facebook page, and the County Assemblies Instagram, and (ii) receive email updates regarding this event.

I, Guest, having read and understood the foregoing, and intending to be bound by the terms hereof, have executed this County Assemblies Informed Consent and Waiver, dated as of today, and my agreement to the terms and conditions contained herein by checking the box below shall for all purposes be deemed my original signature.

I, Guest, agree to all of the terms and conditions contained herein.

I, Guest’s Parent/Guardian, in consideration of Guest being allowed to attend the Charity Ball for which Guest is currently registering, either The 2025 County Assembly Charity Ball for high school juniors or The 2025 Red and White Charity Ball for high school seniors (the Ball for which Guest is registering is hereinafter referred to as the “Charity Ball”) do hereby consent to Guest’s participation in the Charity Ball and hereby represent, warrant, covenant and agree as follows:

a) I hereby assume all risk of injury and all risk of damage to, or loss of, property arising out of Guest’s participation in the Charity Ball;

b) Guest will refrain from consuming any alcohol, non-prescription medication or drugs or using e-cigarettes prior to, during and following said Charity Ball;

c) Guest will submit to a breathalyzer test to gain entrance to said Charity Ball;

d) I understand The County Assemblies is not affiliated with the public schools, and I and Guest hereby release and discharge Region 9 Board of Education, Joel Barlow High School, Fairfield Board of Education, Fairfield Ludlowe High School, Fairfield Warde High School, Weston Board of Education, Weston High School, Westport Board of Education, Staples High School, Wilton Board of Education, Wilton High School (hereafter collectively referred to as “The Schools”) and, The County Assemblies, Inc, its successors and/or assigns, it’s officers, agents, Board of Director’s, and employees (hereafter referred to as “The County Assemblies”) from any and all responsibility and/or liability (including, but not limited to, for death of Guest and damage to property which may be suffered by Guest) in any way relating to, or arising out of, Guest’s participation in the Charity Ball, and I and Guest hereby waive any and all rights and remedies I and/or Guest may have now or hereafter, at law or otherwise, in any way relating to, or arising out of, Guest’s participation in said Charity Ball; and

e) indemnify and hold harmless The County Assemblies and The Schools, against any and all liability, claims, demands, actions, loss, and damage in any way relating to, or arising out of, Guest’s participation in said Charity Ball.

I understand The County Assemblies, Inc. is a 501 (c) (3) organization with no affiliation with the public schools. This informed consent and waiver is governed by the Laws of the State of Connecticut.

I grant permission to The County Assemblies, Inc. to (i) post photos taken during the event to the County Assemblies website, the County Assemblies Facebook page, and the County Assemblies Instagram, and (ii) receive email updates regarding this event.

I, Guest Parent/Guardian: Having read and understood the foregoing, and intending to be bound by the terms hereof, have executed this County Assemblies Informed Consent and Waiver, dated as of today, and my agreement to the terms and conditions contained herein by checking the box below shall for all purposes be deemed my original signature.

I, Guest Parent/Guardian agree to all of the terms and conditions contained herein.