Souris Valley Pet Interment Contract
Memorial Park
1935 20th Avenue SE No. _________
Minot ND 58701
Phone (701) 852-6133
Owners Name __________________________ Date _______________
Address _______________________________ Phone ______________
Pet’s Name ____________________________ City ________________
Sex _________ Date of Birth ____________ Date of Death___________
All caskets and markers must be approved by Souris Valley Memorial Park if not purchased through the cemetery. Pet owners are not purchasing a plot of ground, but are paying for the privilege of having their pet interred in the cemetery plot. All flower arrangements will be kept for a time frame of no longer then 30 days. Pet owners are responsible for weatherizing any permanent ornaments they may put on their pets grave.
Pet picked up at_____________________________ $____10.00_____
Casket/Size________________________________ $______________
Date of Interment________________ Interment Fee $____75.00_____
Interment in Garden of__________________________
Subtotal $_____________
Tax $_____________
Total $_____________
Present for Burial? Y/N Viewing? Y/N
I have requested Souris Valley Pet Memorial Park to take my pet and to inter him/her in the Souris Valley Pet Memorial Park as arranged above. I do hereby agree to pay the above listed fees prior to interment and to abide by the rules and regulations of Souris Valley Memorial Park.
Signature ______________________________________ Date_____________
We at the Souris Valley Pet Memorial Park will endeavor to fulfill all your requests and to develop and maintain a beautiful, dignified, and permanent resting place for your beloved pet.