I am sending the enclosed cremated remains to Parkland Peace to be settled into nature, outside of any container. I understand that it will not be possible to reclaim cremains once they are settled. I hold harmless Parkland Peace, Parkland Peace personnel, and the owner(s) and operator(s) of the estate, park land, or other venue that is the site of the cremains settling.
Signature and date _______________________________________________________________________________________
My name, address, phone number and email address:
My relationship or connection to the person whose cremains are being conferred is that I am his/her:
In the following space, please provide the name of the person whose cremains are to be settled, or a way for us to refer to the person. Additional notations about the person will be appreciated by the cremains bearer who will conduct the settling service.
I authorize the service(s) that I mark and total on this page. Payment is included with this order.
Settlement service location (please select one):
_____ $200. Settlement in an Alpha Site selected by the Parkland Peace team.
_____ $400. Settlement in the land designated by ABC's Good Morning America show in 2011 as the Most Beautiful Place in America: National Park Service's Sleeping Bear Dunes National Lakeshore.
_____ $500 Score Settlement... Special accommodations for eternal athletes and University of Florida friends. I understand that no commemoration or witnessing is available for this settling option.
_____ $2,500. "Honorably Discharged." I will discuss the particulars of viewing options and documentation privately with the explosives orchestrator.
_____ $300. Family Estate. Burial in a Parkland Peace site chosen by the Parkland Peace team.
_____ $100 "My Choice" settling service in a pre-arranged Parkland Peace location. "My Choice" code is __________________________. I understand that this fee is in addition to the fee for settling in either an Alpha Site or in one of these two Distinguished Sites: Family Estate, and Sleeping Bear Dunes National Lakeshore.
Provision and disposition of tribute materials and containers:
_____ No, I am not enclosing materials to be read aloud or played on an audio device during the settling service.
_____ Yes, I am enclosing materials to be read aloud or played on an audio device during the settling service. The materials do not exceed what can be presented in a half-hour ceremony. You may:
_____ Discard the materials upon completion of the settling service. No charge.
_____Return the materials to me upon completion of the settling service. I accept the risk and consequences of loss or damage. $15 for each three pound increment.
_____ Discard the empty cremains container upon completion of the settling service. No charge.
_____ Return the empty cremains container to me upon completion of the settling service. I accept the risk and consequences of loss or damage. $15 for each three pound increment.
Commemoration:
_____ Send a Certificate of Settlement to me upon completion. (Circle one) By mail $25, by email $15.
_____ Send three images of the settlement scenery, photographed by the bearer, to me. (choose one) By mail $25, by email $15.
_____ Have a witness view the settling service and (circle one) photograph or videotape the bearer settling the cremains. Send me the (circle one) prints by mail or images through email. $100.
Please note: If no pictures or digital images are able to be provided, due to equipment malfunction or loss, compensation will be limited to reimbursement of the photography fee that is paid for this commemoration.
_____ Include a remembrance in the Halo Memorial Center. $100.
Payment:
I am enclosing payment to Parkland Peace in the amount of ___________________ for my choices, above.
_________ A check or money order is enclosed.
_________ Charge my credit card.
Visa or Mastercard number _________________________________________
Expiration date and security code ____________________________________
Name on card ____________________________________________________
Address linked to credit card ________________________________________
________________________________________
Requests and Notes:
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