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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
Please provide a personal written statement detailing your religious or sincerely held belief for requesting a vaccination exemption, and explaining why you are requesting this exemption, the principle(s) that guide your informed consent to request a vaccination exemption, and the basis that prohibits the COVID-19 ...
I/we hereby assert that the immunization of this student would be contrary to the religious beliefs of this child. Therefore, this child shall be exempt from the required immunizations under New Jersey administrative Code N.J.A.C.
The Pennsylvania Code § 23.84. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.
California removed its personal and religious exemption option in 2015. Parent/guradian must complete an online educational module to receive a non-medical exemption. Connecticut removed its religious exemption option in 2021.