Clone of Pet Submission from Online Arranger

GENERAL INTAKE FORM

Please provide your information below and answer the following questions so we can best serve you and your cherished companion.
Name of Pet Owner*

First NameLast Name
Name of Pet*

First NameLast Name
Pet's Gender
Date of Pet's Death*

MonthDayYear
Date
Type of Pet*
Please Describe
If dog or cat, provide breed or type. If other, please explain.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
E-mail*
example@example.com
PET TRANSPORTATION

Choose below how you prefer to transport your beloved pet. Please read the following options carefully.
Please note a drop off AFTER business hours is subject to a $175.00 charge. Business hours are Monday - Friday 8:00 AM - 4:00 PM
Please select from the following options:*
Home pick up address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vet address:

Name of Vet

Street Address

CityState / Province

Postal / Zip Code
Danville Drop Off Location: Sunset Memorial Park - 3901 N Vermilion Street, Danville, Illinois 61834

Champaign Drop Off Location: Sunset Funeral Home, Champaign-Urbana Chapel - 710 N Neil Street, Champaign, Illinois 61820
Due to the amount of pets that we handle each week, we cannot be held responsible for blankets, towels, sheets, leashes, toys, collars, or any other type of personal and sentimental property. Please have your pet brought to us in a towel, blanket, or sheet that is suitable to be used in it's final disposition.
CREMATION OR BURIAL
I would like to:*
If you would like to cremate then bury your pet, there will be an option on the cremation form for this.
CREMATION FORM
After cremation I would like to:
Shipping costs are $50.00. This fee is for shipping your pet via USPS. We recommend purchasing the Natural Photo Urn or the Simplicity Faux Wood Urn to prevent damage during shipping. Please provide shipping information below.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
A Team Member from Sunset Memorial Park will reach out to you shortly to walk you through the options of burying your pet's cremated remains at Sunset Memorial Park.
CREMATION AUTHORIZATION

Please read carefully and sign below.
0-5 lbs ($200.00)6-50 lbs ($250.00)51-99 lbs ($300.00)100+ lbs ($400.00)
Pet Cremation Authorization

I/We, the undersigned, do hereby certify and represent that I/We are the owner, or duly authorized agent for the owner of the animal described below. It is my/our desire to to provide for said pet's decent and humane after-death care, complying with all legal requirements of the State of Illinois. I/We do hereby convey the remains of my pet to Sunset's Cherished Companions Pet Crematory and/or its agents, to arrange for the cremation and disposition of said pet. I/We understand that Sunset will provide a private cremation of my pet which means there will be no other pet involved during this cremation. I/We also understand that this will take time, and I/We understand that it will take up to 7 to 10 days before my pet's remains are available to us during busy periods of the crematory. I/We agree to hold harmless the above named organization, its officers, agents, and employees from any claims, suits, or causes of action arising out of the final disposition of above said pet. I/We also understand that any item brought in with the pet such as blankets, toys, or leashes, will be cremated with the pet. Sunset's Cherished Companions pet crematory will not be held responsible for the return of these items. It is recommended that the pet be brought in with only those items that do not have significant emotional value. I/We understand that if no arrangements are made by said owner to retrieve/ ship the cremated remains within 60 days of the date of cremation, Sunset's Cherished Companions can properly dispose of the cremated remains at their discretion. I/We also certify that my pet's remains do not contain a pacemaker, radioactive implant, or any other device that could be harmful to the crematory and that they are safe to cremate.
Signature

Clear
Type Name: Date
BURIAL FORM

A Team Member will be in contact with you shortly about our burial options.
TOTAL
Your Total:

Should be Empty:

GENERAL INTAKE FORM

PET TRANSPORTATION

CREMATION OR BURIAL

CREMATION FORM

CREMATION AUTHORIZATION

BURIAL FORM

TOTAL

Credit Card