Register Registration for the 2025 Charity Balls opens on October 20, 2024 HiddenYear HiddenEvent ID HiddenEvent NameCounty Assembly Charity Ball - Westport, Weston, WiltonCounty Assembly Charity Ball - Easton, Fairfield, ReddingRed and White Charity Ball - Westport, Weston, WiltonRed and White Charity Ball - Easton, Fairfield, ReddingRegister now to attend! Registration is $210 per couple. Please sign (check) the Informed Consent and Waiver at the bottom of this form. By signing you agree to be bound by the terms hereof. Completing registration creates your account on this website. Using this account, you may: Invite your guest (required) Send a consent form to your parent / guardian (required) Send a consent form to your guest's parent / guardian (required) Make a donation to County Assemblies Thank you! Main Registrant Email* Fee Waived Your registration fee has been waived. Main Registrant Name* First Last Password* Enter Password Confirm Password Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mobile Phone*SMS Text Messages YES, I want to receive SMS text messages from County Assemblies County Assemblies will only text you with reminders / information regarding your registered event. You may opt out of receiving messages by replying with the word STOP.Town*Please SelectEastonFairfieldReddingWestonWestportWiltonSchool*– Fill Out Other Fields –Your Private School Grade*Please SelectJuniorSenior You will be attending: 87th County Assembly Charity Ball Saturday, January 25, 2025 7:30 - 10:30 pm For members of the Class of 2026 from the towns of Westport, Weston and Wilton and their guest / escort. You will be attending: 87th County Assembly Charity Ball Friday, January 24, 2025 7:30 - 10:30 pm For members of the Class of 2026 from the towns of Easton, Fairfield and Redding and their guest / escort. You will be attending: 87th Red and White Charity Ball Friday, January 31, 2025 7:30 - 10:30 pm For members of the Class of 2025 from the towns of Westport, Weston and Wilton and their guest / escort. You will be attending: 87th Red and White Charity Ball Saturday, February 1, 2025 7:30 - 10:30 pm For members of the Class of 2025 from the towns of Easton, Fairfield and Redding and their guest / escort. Informed Consent and Waiver*I, Main Registrant, 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 Main Registrant 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 Assemblies 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, Junior/Senior Main Registrant: Having read and understood the foregoing, and intending to be bound by the terms hereof, I have executed this County Assemblies Informed Consent and Waiver, time/date-stamped 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 agree to all of the terms and conditions contained herein. I agree to all of the terms and conditions contained herein as of this day. Scroll down through the Informed Consent and Waivers to activate the 'I agree' checkbox above.Payment DetailsThe registration fee is $210 per couple. Please choose your payment method below. If you choose Paypal, you will be redirected to their website to complete your payment.Registration FeePayment MethodCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name DonationWould you like to donate $10 to help offset the Registration cost for a student in need? Yes, I would like to donate $10 $10 Registration Offset Donation Price: I would like to make an additional donation to County Assemblies. $25 $50 $75 $100 Custom Donation Amount Total $0.00 HiddenEMail Address ChangeDon't send an SMS notificationSEND an SMS notification