To book an attended ash scattering with Pacific Coast Ashes at Sea, this contract can be printed, completed and mailed to Pacific Coast Ashes at sea along with payment and the ashes.

PACIFIC COAST ASHES AT SEA

CORPORATE OFFICE:  22 Aquarium Way, Long Beach, CA 90802
Toll-free: 800-900-8188; Tel: 562-437-5046; Fax: 562-983-6883

Event     Unattended Memorial at sea            C/O                                     
Tel:
                                    
Email:                                                     
Address:                                                                                                               
Trip Price            $195      

Payment due upon receipt

 

Date Reservation Taken                     
Taken By                             

 

Charter Contract, Confirmation and Terms

I hereby authorize PACIFIC COAST ASHES AT SEA to take possession of and make arrangements for, the disposition of the cremated remains of ______________________________________________ ("Deceased") in accordance with and subject to the terms and conditions set forth in this Authorization; the Company's Rules and Regulations; and any applicable federal, state, provincial or local laws and regulations.  I certify that I have the full legal right and authority to authorize the disposition of the remains of the Deceased.

I hereby authorize PACIFIC COAST ASHES AT SEA to make disposition of cremated remains of the Deceased at sea in the Pacific Ocean.

I hereby direct PACIFIC COAST ASHES AT SEA to scatter said cremated remains at sea, in accordance with State and Federal Law.

Special Instructions:
____________________________________________________________

If no specific instructions are provided herein, scattering will be performed by PACIFIC COAST ASHES AT SEA, in a timely manner, weather permitting.
"Scattering" consists of the scattering of cremated remains at sea. I understand that once the cremated remains of the Deceased are scattered, they are unrecoverable. Unless otherwise specifically provided for herein, once scattering of cremated remains of the Deceased has been performed, PACIFIC COAST ASHES AT SEA will dispose of the container which contained said cremated remains.  The obligation of PACIFIC COAST ASHES AT SEA shall be limited to the disposition of the cremated remains as directed herein. I agree to release and hold harmless PACIFIC COAST ASHES AT SEA, its affiliates and their agents, employees, successors and assigns from any and all loss, damage, liability or causes of action (including attorney's fee and expenses of litigation) in connection with the disposition of the cremated remains of the Deceased as authorized herein or respect to the identification of said cremated remains as being those of the Deceased.

The client is responsible to deliver the ashes and the Disposition Permit to Pacific Coast Ashes at Sea.

PLEASE SIGN AND RETURN WITH PAYMENT AND ASHES TO PACIFIC COAST ASHES AT SEA, 22 Aquarium Way, Long Beach, CA 90802 or by FAX at (562) 983-6883. 

CHECKS CAN BE MADE PAYABLE TO HARBOR BREEZE CRUISES, OUR PARENT COMPANY.

All payments are non refundable. Gratuity for the crew is not included in the price.


Accepted by:                                           Date: