Affidavit to release body with hold harmless

  • I,
  • representing myself and
  • hereby authorize the transfer of the remains of
  • to
  • I understand that this in no way releases the obligation for payment for any services already performed by Hempstead/Senko Funeral Home, it’s agents and assigns. Furthermore, I,
  • declare that I have the legal authority to authorize this release and I, my designee(s) and representative(s), agree to indemnify and hold harmless Hempstead Funeral Home, it’s employees, agents and assigns, of and from all claims, actions, causes of action and losses, including reasonable attorney fees and court costs, arising out of or in any way related to any matter and/or endeavor undertaken by Hempstead Funeral Home, it’s employees, agents and assigns in the original and current transfers of remains, the arrangements including any and all coordination of service plans, the preparation, and/or custodial care of the remains of
  • Date Format: MM slash DD slash YYYY
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