and as such has the legal authority to give the permission required for Society to provide services described below.

(“The Decedent”), and, as such, by their relationship, has the paramount right to direct the disposition of the body of the Decedent. After giving this authorization the undersigned shall hold Society harmless from following their directions. The undersigned, understanding that embalming is not required by law except in certain special cases, authorizes and directs Society to transport, care for, embalm, prepare the body of the Decedent as directed, and obtain fingerprints for identification and other purposes (“Services”). Society may use its employees, independent contractors, and agents (including apprentices and/or mortuary students under the direct supervision of a licensed embalmer) to provide these services at the Society facility or at another facility equipped for providing these services.

The undersigned, who represents the deceased, hereby declares that having the legal authority to authorize embalming, gives Society permission to perform all of the above Services except they withhold permission to embalm the above-named-deceased individual. Society cannot be held responsible for any limitations in funeral options caused by this withholding of embalming authorization.