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This agreement, by and between _____________________________________________,

whose address is

________________________________________________________________________

________________________________________________________________________,

(hereinafter referred to as the "Patient") and

________________________________________________________________________

whose address is

________________________________________________________________________

________________________________________________________________________,

(hereinafter referred to as the "Next of Kin")

WHEREAS, the Next of Kin may have some involvement in the disposition of the Patient's body upon the Patient’s death;

In consideration of the family relationship between the Patient and the Next of Kin and for $1.00, receipt of which is acknowledged by the Next of Kin, the Next agrees to the following:

1. The Next of Kin hereby assigns to the Cryonics Institute (a Michigan nonprofit corporation, hereinafter "CI") all his rights to and interest in the control of the disposition of the Patient's body after the Patient's death.
2. The Next of Kin shall take all actions reasonably necessary to permit, and shall forgo all actions which might interfere with, the cryopreservation of the Patient in accordance with the terms of the Contract, including, without limitation, any additional documentary designations of CI to receive the Patient's body immediately upon the Patient's death as deemed desirable by CI and the execution of all documents provided by CI to make such designations effective.
3. The Next of Kin intends that CI shall be a third party beneficiary of this Agreement, and agrees that CI shall have the right to enforce this Agreement in a court of law.
4. The Next of Kin acknowledges that its breach of this Agreement would cause irreparable injury to the Patient and CI, and agrees that upon a breach of this agreement, CI may obtain, without bond, preliminary and permanent injunctions prohibiting any breaches of this Agreement by the Next of Kin, whether such breaches are by way of action or omission.
5. The Next of Kin agrees that this Agreement is reasonably related to the State of Michigan, and that the provisions of this Agreement are to be interpreted and enforced according to the provisions of Michigan law. Any lawsuit brought concerning the interpretation or enforcement of the Agreement or the Next of Kin's actions with respect to the disposition of the Patient's body shall be brought in a state court in Macomb County, Michigan or a federal court in the Eastern District of the State of Michigan.

IN WITNESS WHEREOF, the parties have signed this Agreement, which is finally executed at

Clinton Township, Michigan.

Patient's Signature ___________________________________, dated ______________

Next-of-Kin's Signature _______________________________, dated ______________

Subscribed and sworn to before me this _____ day of ________________________________

Signature of Notary Public _____________________________________________________

Name of Notary ________________________ County and State _______________________

If two witnesses are used instead of a notary, for each witness please show signature, printed name, address, and date:

Witness 1 Signature __________________________________________Date ____________

Printed Name _______________________________________________________________

Address ___________________________________________________________________

Witness 2 Signature __________________________________________Date ____________

Printed Name _______________________________________________________________

Address ___________________________________________________________________