Religious waiver

[Guest guest]

Can someone tell me what to do regarding getting a religious waiver for

immunizations for my preschooler and toddler? The health dept (Floyd

County) says all we have to do is type up a statement and have it notarized.

Any suggestions about wording?

Thanks!

Jodi

[Guest guest]

Something like this:

July 19, 2001

ABC County School System100 Pinetree Ave.Atlanta, GA 31706

Re: Immunizations waiver

To whom it may concern:

We are requesting a religious exemption based on personal religious tenets and practices as per Education, Part III, Health, Ga. Code Ann. §20-2-771. Rules of Department of Human Resources Public Health, Ga. Comp. R. & Regs. §290-5-4-. 01 to .09. for our children. We believe immunizations directly violate our religious beliefs. Because of our religious belief, our children will not receive all the immunizations required by the state.

CHILD Birth Date SSN

Thanking you very much for your cooperation in this matter.

Very truly yours,

____________________

A. Doe, Father

cc: Family File Copy

NOTARY:

Sworn before me this day

____,______ 200_

____________________

Religious waiver

Can someone tell me what to do regarding getting a religious waiver forimmunizations for my preschooler and toddler? The health dept (FloydCounty) says all we have to do is type up a statement and have it notarized.Any suggestions about wording?Thanks!Jodi

[Guest guest]

Here is an example: VACCINATION EXEMPTION PURSUANT TO THE OFFICIAL CODE OF GEORGIA ANNOTATED ˜ 20-2-771 4. (e) This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages. For a child to be exempt from

immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian. ________________________________________________________________________________ VACCINE EXEMPTION FORM I,____________________________, as the parent, guardian or person in (insert your name) loco parentis of the child __________________________, hereby certify that the (insert your childfs name) administration of any vaccine or other immunizing agents is contrary to our religious beliefs.   Diphtheria   Measles   Other   Tetanus   Mumps   Pertussis   Rubella   Polio   Haemophilus influenzae type b   Hepatitis B   Varicella   Smallpox   Anthrax This is pursuant to my right to refuse vaccination on the grounds that vaccinations conflict with my religious beliefs. Pursuant to Georgia statute I am

providing a copy of this statement to our childfs school administrator or operator of the group program pursuant to O.C.G.A. ˜ 20-2-771 (4e). Parent __________________________________ Date _______________ Parent __________________________________ Date _______________ Subscribed and Sworn before me this _____ day of ___________, 20____. ________________________________________ Notary's Signature and Seal

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