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land Exemption

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Thanks to all who provided the links to this. I figured this is what I will send

to the school. Seems easy enough. But for some reason, I still have butterflies

in my stomach. Like they are going to give me a hard time.

VACCINATION EXEMPTION PURSUANT TO THE

MARYLAND STATUTE § 7-403

§7-403 (B) Exception.

(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or

an epidemic of disease, a child whose parent or guardian objects to immunization

on the ground that it conflicts with the parent’s or guardian’s bona fide

religious beliefs and practices may not be required to present a physician’s

certificate of immunization in order to be admitted to school

(2) The Secretary of Health and Mental Hygiene shall adopt rules and

regulations for religious exemptions under this subsection.

________________________________________________________________________________\

_______

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 child’s name)

administration of any vaccine or other immunizing agents is contrary to our

personal

religious beliefs.

â–¡ Diphtheria â–¡ Measles â–¡ Other

â–¡ Tetanus â–¡ Mumps

â–¡ Pertussis â–¡ Rubella

â–¡ Polio â–¡ Haemophilus

influenzae type b

â–¡ Hepatitis B â–¡ Varicella

â–¡ Smallpox â–¡ Anthrax

This is pursuant to my right to refuse vaccination on the grounds that

vaccinations conflict with my bona fide religious beliefs. Pursuant to land

statute I am providing a copy of this statement to our child’s school

administrator or operator of the group program pursuant to land Statute §

7-403.

Parent __________________________________ Date _______________

Parent __________________________________ Date _______________

Subscribed and Sworn before me this _____ day of ___________, 20____.

________________________________________

Notary's Signature and Seal

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