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PET RELEASE/ AUTHORIZATION FOR FINAL DISPOSITION FORM

PawsPetCremation.com
3537 E. 16th St.,
Los Angeles, CA 90023
855-729-7738

PET RELEASE AND AUTHORIZATION OF CREMATION
I/We authorize the private cremation of the pets remains by Paws Pet Cremation and warrant that I/we are the Owner or Authorized Agent of this pet. I/We understand all cremation fees and services and acknowlege that full payment is required prior to cremation and is due to Paws Pet Cremation within 5 days or I/We may be subject to storage fees.

A PRIVATE CREMATION is a cremation procedure during which only one animal's body is present in the cremation chamber during the cremation process.

This authorization for cremation and disposition was executed at March 29, 2020.

I/we understand that Paws Pet Cremation reserves the right to scatter all cremated remains that are unclaimed for more than 60 days. I/we understand that I/we am responsible to pick up my pet's cremated remains or coordinate a delivery of my pet's cremated remains within 60 days of completed cremation date.

First Pet Owner Name

First Name*

Last Name*

Phone*
First Pet Owner Date of Birth*
I certify that I am 18 years of age or older
First Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
First Pet Owner Signature*
Second Pet Owner Name

First Name*

Last Name*
Second Pet Owner Date of Birth*
Second Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Third Pet Owner Name

First Name*

Last Name*
Third Pet Owner Date of Birth*
Third Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Fourth Pet Owner Name

First Name*

Last Name*
Fourth Pet Owner Date of Birth*
Fourth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Fifth Pet Owner Name

First Name*

Last Name*
Fifth Pet Owner Date of Birth*
Fifth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Sixth Pet Owner Name

First Name*

Last Name*
Sixth Pet Owner Date of Birth*
Sixth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Seventh Pet Owner Name

First Name*

Last Name*
Seventh Pet Owner Date of Birth*
Seventh Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Eighth Pet Owner Name

First Name*

Last Name*
Eighth Pet Owner Date of Birth*
Eighth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Ninth Pet Owner Name

First Name*

Last Name*
Ninth Pet Owner Date of Birth*
Ninth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Tenth Pet Owner Name

First Name*

Last Name*
Tenth Pet Owner Date of Birth*
Tenth Pet Owner 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Pet Owner Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
OPTIONAL SERVICES
Select Service Package*
PET TRANSPORTATION ARRANGEMENTS (pick up fees may apply)*
Currently not offering pick up services
I will bring in my pet to facility door and call upon arrival
N/A

Pick Up Location: (Name & Address) or N/A for non applicable *
Do you need to add an extra Ink Paw Print in a Personalized Frame ($30 each)? Be advised one is already included in our Signature cremation service*
Do you need to add a Clay Paw print impression ($30 each)? Available in White or Terra-cotta.*

Notes/ Special Instructions

Visit www.PawsPetCremation.com to view a full summary of our services.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's 's Pet Information

Pet Name *

Pet Type (Dog, Cat, Bird...etc) *

Breed

Pet Weight (approx. in lbs) *
Gender*
Male
Female
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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