Authorization For Cremation

Direct Cremation of the Seacoast
HAMPTON, NH 03842
I (We), the undersigned (the "Authorizing Agent(s)"), hereby authorize and request the Direct Cremation of the Seacoast, in accordance with and subject to its rules and regulations, and all applicable state or local regulations, to cremate the human remains of:
Name of Decedent*

(the"decedent')
Who resided at:*
I (We) attest that the human remains that were delivered to the Direct Cremation of the Seacoast is the decedent, and have authorized the Direct Cremation of the Seacoast to deliver the decedent to the crematory, for cremation.

I (We) authorize the crematory to perform the cremation upon receipt of the human remains, at its discretion, and according to its own time schedules and state laws, as work permits, without obtaining any further authorization or instructions.

I (We) state that the decedent does not have a heart pacemaker, radiation producing implant or other life-sustaining device that could be explosive. If such a device exists, I (We) will instruct the funeral director or others to remove such object prior to cremation. I (We) also agree that in the event of my (our) failure to notify the Direct Cremation of the Seacoast or others responsible for removal of such a device, I (We) shall be liable, for any damages to the crematory or injury to crematory personnel.
If the undersigned authorizes the crematory to deliver the cremated remains via any postage or freight service carrier, they agree to have assumed all liability for damages that may arise from any cause growing out of said delivery and will indemnify and hold harmless the crematory and Direct Cremation of the Seacoast from any and all claims related to such delivery.
I (We) certify that I (We) am/are related to the deceased as:
Relationship to Deceased*
or That I (We) otherwise serve in the capacity of:
*
to the decedent. I (We) have the right to authorize this cremation and disposition of the cremated remains. I understand that due to the nature of the cremation process any valuable material or objects, including jewelry and dental gold, will be either destroyed or not recoverable. Any personal possessions accordingly have either been removed or left with the intention of them being destroyed.

I (We) have read the opposite side of this document entitled " Direct Cremation of the Seacoast Policies, Procedures, and Requirements," and hereby authorize them to perform the cremation of the decedent listed in accordance with this document.

As the Authorizing Agent(s), I hereby agree to indemnify, defend, and hold harmless the Direct Cremation of the Seacoast, its officers, agents and employees, of and from any and all claims, demands, causes or causes of action, suits of any kind, nature and description, in law or equity, including any legal fees, costs and expenses of litigation, arising as a result or, based upon or connected with this authorization, including the failure to properly identify the decedent or the human remains transported to the crematory, the processing, shipping and final disposition of the decedent's remains, any damage due to harmful or explosive implants, claims brought by any other person(s) claiming the right to control the cremation or disposition of the decedent or the decedent's cremated remains, or any other action performed by the Crematory, its officers, agents or employees, pursuant to this authorization, excepting only acts of willful negligence.

By executing this Cremation Authorization, as Authorizing Agent(s), the undersigned warrant that all representations and statements contained on this form are true and correct, that these statements are made to induce Direct Cremation of the Seacoast to cremate the human remains of the decedent, and that the undersigned have read and understand the provisions contained within this document.
Executed this*

Date
Day of*

Month
Year*
Signature*
Name:*
Address:*
City:*
State:*
Zip:*
Signature*
Name:*
Address:*
State:*
Zip:*
City:*
(For Office Use Only)
Place of Death:*
Date of Death:*
MM slash DD slash YYYY
Identification:*
- In Person
- By Photo
Funeral Director Signature
DIRECT CREMATION OF THE SEACOAST
Policies, Procedures and Requirements The cremation, processing and disposition of the remains of the deceased shall be performed in accordance with all governing laws, policies, procedures and requirements of Direct Cremation of the Seacoast, and the designated crematory.
Requirements for Cremation
The crematory will require the following conditions be met before cremation can take place: (1) 48 hours have transpired since the time of death. (2) Civil and medical authorities have issued all permits. (3) All necessary authorizations have been obtained. (4) Positive identification of deceased.

Caskets/Solid Containers
The crematory requires either a casket or alternative container, as described per NH RSA 325-A:21, for cremation. Many caskets that are comprised primarily of combustible material also contain some parts, e.g., decorative handles or rails and metal beds, that are not combustible and that may cause damage to the cremation equipment. The crematory, at its discretion reserves the right to remove these non-combustible materials prior to cremation and to discard them with similar materials from other cremations and other refuse in a non-recoverable manner. The crematory strongly discourages the use of metal caskets; as such caskets are inappropriate for cremation and the cremation equipment. If such a casket is purchased and delivered to the crematory, then the crematory, at its sole discretion, reserves the right to take any or all the following steps to facilitate the cremation: to remove the casket or casket lid prior to cremation; or to cut additional openings in the casket. Following the cremation, the remnants of the metal casket shell will be manually or mechanically reduced in size so that it may be discarded in an economical manner with similar materials form other cremations and other refuse in a non-recoverable manner. The Authorizing Agents(s) will be responsible for any costs involved in the disposition of a metal casket

Pacemakers, Prostheses and Radioactive Devices
Pacemakers and prostheses, as well as any other mechanical or radioactive devices or implants in the decedent may create a hazardous condition when placed in the cremation chamber. It is imperative that pacemakers and radioactive devices be removed prior to cremation. If the crematory is not notified about such devices and implants, and not instructed to remove them, then the person(s) authorizing the cremation will be responsible for any damages caused to the crematory or crematory personnel by such devices or implants.

The Cremation Process
All cremations are performed individually,
Cremation is performed by placing the deceased in a casket or other solid container and placing the casket or container into a cremation chamber or retort, where they are subject to intense heat and flame. During the cremation process, it may be necessary to open the cremation chamber and reposition the deceased in order to facilitate a complete and thorough cremation. Through the use of a suitable fuel, incineration of the container and contents is accomplished and all substances are consumed or driven off, except bone fragments (calcium compounds) and metal (including dental gold, silver and other non-human material) as the temperature is not sufficient to consume them. Due to the nature of the cremation process any personal possessions or valuable materials, such as dental gold or jewelry (as well as anybody prosthesis or dental bridgework), that are left with the decedent and not removed from the casket or container prior to cremation will be destroyed or if not destroyed, will be disposed of by the crematory. As the casket or container will not normally be opened by the crematory, arrangements must be made with the Direct Cremation of the Seacoast to remove any such possessions or valuables prior to the time that the decedent is transported to the crematory. Following a cooling period, the cremated remains, which will normally weigh several pounds in the case of an average adult, are then swept or raked from the cremation chamber. The crematory makes a reasonable effort to remove all of the cremated remains from, the cremation chamber, but it is impossible to remove all of them, as some dust and other residue from the process are always left behind. In addition, while every effort will be made to avoid commingling, inadvertent or incidental commingling of minute particles of cremated remains from the previous cremations is a possibility. After the cremated remains are removed from the cremation chamber, all non-combustible materials (insofar as possible), such as bridgework. and materials from the casket or container, such as hinges, latches, nails, etc., will be separated and removed from the human bone fragments by visible or magnetic selection and will be disposed of by the crematory with similar materials from other cremations in a non-recoverable manner. After the bone fragments have been separated from the other materials, they will then be mechanically processed (pulverized). This process of crushing or grinding may cause incidental commingling of the remains with the residue from the processing of previously cremated remains. These granulated particles of unidentifiable dimensions will be virtually unrecognizable as human remains. After the cremated remains have been processed, they will be placed in the designated urn or temporary container. The crematory will make a reasonable effort to put all the cremated remains in the urn or temporary container, with the exception of dust or other residue that may remain on the processing equipment in the event the urn or temporary container provided is insufficient to accommodate all of the cremated remains, the excess will be placed in a separate container. The separate container will be kept with the primary container and handled according to the disposition instructions on the Cremation Authorization.

Final Disposition
Cremation is NOT the final disposition, nor is placing the cremated remains in storage at a funeral home or Direct Cremation of the Seacoast considered final disposition. The cremation process simply reduces the decedent's body to cremated remains. These cremated remains usually weigh several pounds and usually measure in excess of 150 cubic inches. Some provision must be made for the final disposition of these cremated remains. Therefore, the crematory strongly suggests that arrangements for final disposition be made at the time that the cremation arrangements are made.

Limitation of Liability
The obligations of Direct Cremation of the Seacoast shall be limited to the cremation of the decedent's cremated remains as authorized on the Cremation Authorization. No Warranties Express or Implied are Made and Damages Shall be Limited to the Amount of the Cremation Fee Paid.
Name
This field is for validation purposes and should be left unchanged.