Cemetery Services Waiver Form
Complete this Cemetery Services Waiver Form to request cemetery services, provide site details, and acknowledge the terms required to proceed.
Full Name of Participant/Client
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Decedent
*
Please Select
Family Member
Friend
Funeral Director
Legal Representative
Other
Decedent's Full Name
*
First Name
Last Name
Cemetery Location or Plot Number
*
Type of Service Requested
*
Please Select
Interment/Burial
Disinterment
Grave Marker Installation
Grave Maintenance
Other
Preferred Date for Service
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Special Instructions or Requests
Cemetery Services Waiver Form Waiver and Acknowledgment: By signing below, I acknowledge that I have read, understood, and agree to the terms and conditions outlined in the Cemetery Services Waiver Form. I understand that cemetery services are provided as requested and release the cemetery and its representatives from liability as described in this form.
Signature (Required to Submit the Cemetery Services Waiver Form)
*
Submit Cemetery Services Waiver Form
Submit Cemetery Services Waiver Form
Should be Empty: