The United Church of Los Alamos

Columbarium Agreement

For and in consideration of $ _______________, The United Church of Los Alamos grants unto

________________________________ (the Grantee) the exclusive right and privilege to inter the cremains of

________________________________ who qualifies to have their cremains in
     Name of Deceased

niche #_________________(if the location you selected is not available we will notify you)
                         Niche Location Number

of the Columbarium located at The United Church of Los Alamos, 2525 Canyon Road, Los Alamos, New Mexico.

The Grantee agrees to abide by the Policies governing the Columbarium.  The United Church of Los Alamos reserves the right to make reasonable change in the Policies as deemed necessary.  By signing this Columbarium Agreement, the Grantee acknowledges having received and read a copy of the Policies.

This Columbarium Agreement is binding on all parties, their representatives, administrators, executors, heirs, assigns and successors.  This Columbarium Agreement shall not create any interest in the real property on which the Columbarium is located.

IN WITNESS WHEREOF, this agreement has been issued this _____ day of ____________,

in the year ___________.

_____________________________________________________________________       
             Address                                     

Phone ______________ E-Mail ________________

_________________________________________      ____________________________
               Relation to Deceased                             Date
 

Endorsed
Executive Board
27 March 2001