Owner's Name *

First Name

Last Name

Phone *

(###)

###

####

Collection & Pickup *

Gentle Waves offers door-to-door collection services. The cost depends on the distance from your location to our facility.

No (Self Drop-Off)

Yes

Preferred Date *

MM

DD

YYYY

I give Gentle Waves permission to display my pet’s photo in-store or online as part of a remembrance tribute to honour their life.

Authorisation *

I certify that I am the legal owner (or duly authorised representative of the owner) of the above-named pet. I hereby authorise Gentle Waves Pet Cremation to take possession of and arrange for the water cremation of my pet.