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Please sign the Informed Consent and Waiver, by signing you agree to be bound by the terms hereof. Attendee's Parent/Guardian and Escort along with their Parent/Guardian can be added upon login and must agree to these terms and submit their acceptance electronically.

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Informed Consent and Waiver

Subscriber and Subscriber's Parent/Guardian (hereinafter collectively referred to as “We") in consideration of Subscriber being allowed to attend the Charity Ball for which the Subscriber is currently registering, either The 2019 County Assembly Charity Ball for juniors or The 2019 Red and White Charity Ball for seniors (the Ball for which Subscriber is registering is hereinafter referred to as the “Charity Ball”) do hereby consent to Subscriber’s participation in the Charity Ball and hereby represent, warrant, covenant and agree as follows: a) We hereby assume all risk of injury and all risk of damage to, or loss of, property arising out of Subscriber’s participation in this Charity Ball; b) the Subscriber will refrain from consuming any alcohol or non-prescription medication or drugs prior to, during and following said Charity Ball; c) the Subscriber will submit to a breathalyzer test to gain entrance to said Charity Ball; d) We 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, Westport 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 Subscriber and damage to property which may be suffered by Subscriber) in any way relating to, or arising out of, the Subscriber’s participation in the Charity Ball, and hereby waive any and all rights and remedies We may have now or hereafter, at law or otherwise, in any way relating to, or arising out of, the Subscriber’s participation in said Charity Ball; and e) indemnify and hold harmless The Schools and The County Assemblies, against any and all liability, claims, demands, actions, loss, and damage in any way relating to, or arising out of, Subscriber’s participation in said Charity Ball.

We 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. We 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.

Junior/Senior Girl Subscriber: 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, dated as of November 9, 2018, 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 Girl Subscriber 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.