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Authorization to Cremate

Authorization to Cremate

  • I,
  • hereby state that I am the
  • and Legal Next of Kin of
  • who died on
  • and I hereby authorize Hempstead Funeral Home to arrange the cremation of the heretofore said late
  • I hereby state under penalties of law that I have the legal authority to give this authorization. I,
  • and my successors and assigns, do hereby release and forever discharge Hempstead Funeral Home, together with their officers, directors, agents and their successors and assigns, jointly and severally from any and all claims, causes of action, actions, complaints, contracts or covenants whether expressed or implied, which the undersigned may have or may hereafter claim to have against Hempstead Funeral Home, John Senko, Inc., arising with respect to or as a result of, any cause, matter or implication associated in the performance of cremating said
  • In addition, the undersigned hereby waives any rights that he or she or his/her family may have to make claim against the said Hempstead Funeral Home officers, directors and agents or their successors to any act now or in future in force and effect: I hereby agree to hold harmless Hempstead Funeral Home, their agents and assigns from any actions or proceedings which may arise from said arrangements and/or authorization.