Authorization for the Burial at Sea of Cremated Remains

I/We the undersigned hereby request and authorize Tradewind Charters, Inc. dba HawaiiAshScatterings.com (hereby referred to as the "Company") to take possession of and make arrangements for, the dissemination of the cremated remains of

, (hereafter referred to as the "Deceased") in accordance with and subject to: a) the terms and conditions set forth in this authorization; b) the Company's Rules and regulations; and c) any applicable federal, state, or local laws and regulations. I/We certify, warrant and represent that I/We have the full legal right and authority to authorize the dissemination of the remains of the deceased. I/We hereby authorize the Company to disseminate the cremated remains of the Deceased at sea in the offshore waters of the State of Hawaii. I/We hereby direct the Company to disseminate said cremated remains at sea, in accordance with State and Federal Law.

"Burial at Sea" consists of the scattering of cremated remains at sea. I understand that once the cremated remains of the Deceased are scattered, they are unrecoverable. Unless otherwise specifically provided for herein, once scattering of cremated remains of the Deceased has been performed, the Company will dispose of the container which contained said cremated remains. The obligation of the Company shall be limited to the disposition of the cremated remains as directed herein. I agree to release and hold harmless the Company, its affiliates and their agents, their employees & contractors, successors and assigns from any and all loss, damage, liability or causes of action (including attorney's fees and expenses of litigation) in connection with the disposition of the cremated remains of the Deceased as authorized herein or respect to the identification of said cremated remains as being those of the Deceased.