print this page and fill out the necessary information, and mail
authorize "Ashes in Paradise" to charge the applicable
fees ($275.00) for services requested regarding the scattering
of cremains to my credit card as follows:
_______ _______ Expiration: ____ / _____
Name on Card:
If I request any additional services besides
the regular ocean scattering ( $275) I authorize those additional
costs to also be charged to my credit card above.
** any charges will show up on your credit
card statement as being from "Rainbow Moon", which is the
name our merchant account is under.
Mail completed form, or check to :
Ashes in Paradise
Attn.: Capt. Ken Arnopole
P.O. Box 699
Volcano, HI 96785
If you have any
questions, please don't hesitate to contact
us via email or call us at 808-987-0920 (USA) / 808-987-0920
(international / local).