I hereby authorize Worlds Away Charters 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 the authorization; the Company's Rules and Regulations, and applicable federal, state, or local laws and regulations. I certify that I have the full legal right and authority to authorize the disposition of the cremated remains of the deceased.
I hereby authorize Worlds Away Charters to make disposition of cremated remains of the deceased into the Gulf of Mexico.
I hereby direct Worlds Away Charters to scatter said cremated reamins at sea, by vessel, in accordance with State and Federal Law.
If no specific instructions are provided herein, scattering will be performed by Worlds Away Charters in a timely manner, weather permitting.
The obligation of Worlds Away Charters shall be limited to the disposition of the cremated remains as directed herein, I agree to release and hold harmless Worlds Away Charters. It's affiliates and their agents, employees, successors and assigns from any and all loss, damage, liability or causes of action (including attorney's fee and expense 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.
Signature:_____________________________________________
Printed Name:__________________________________________________
Address:___________________________________________
City, State, Zip:__________________________________
Telephone:_________________________________________
Relationship to deceased:__________________________
Mail To:
Worlds Away Charters, 2059 Southpointe Dr, Dunedin, Florida,34698
Checks Payable:
Captain Steve Allen