Release Form - Cremation Services By The Sea

Authorization Granted To: (Select) *

CREMATION SERVICES BY THE SEA - 1307 Central Ter. Lake Worth, FL 33460. Phone (561) 623-7357

Release Authorization Form *

The undersigned (below) being the nearest degree of relationship to the deceased, hereby, grants full authorization for Cremation Services By The Sea, LLC to remove the deceased from the below facility, provide transportation for the purpose of and approval of cremation of the deceased by use of this form. The signature listed below is that of the requesting legal authorized individual, including prepaid or pre-need self arranged contracts for such action to take place effectively on the date listed.

Name of Deceased *

Name of Institution (Current Custody) * 🛈

If Other Institution or Prepaid Self Arranged, Update Here At Time Of Need.

Relationship to Decedent *

Authorized Individual (Including Self Arrangement) or Next of Kin *

Authorizing Individual's Email *

Next of Kin Address (or legal Authorized Indiv.) *

Date *

Phone Number *

Authorizing Individual's Signature * 🛈

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