Natalia Rose Institute Natalia Rose Institute

School Vaccination Waiver Sample

Your Name
Your Address
Your Contact Phone


School Contact Name
School Name
School Address

Dear X,

This is to clarify that we have chosen not to continue to vaccinate our child, NAME, for religious
reasons. It is our belief that our bodies are sacred — that the blood chemistry and cellular integrity that makes up our body must not be compromised and defiled by the viruses, synthetics, heavy metals and animal derivatives contained in the suggested vaccines. We believe that these contents are agents of cellular abnormalities. We feel that the negative effects they inflict far outweigh their benefits. We also feel that defiling the body in this way is an insult to our Creator’s design for the human being and thereby defies God’s will.

We greatly appreciate your consideration of this matter and are available to answer any further
questions you may have.


Your Name

Disclaimer of Health Related Information
This site and all of its contents including all courses and cleanses is a source of information only. The information contained in this site, on our recorded calls, and in all Course and/or Cleanse materials should by no means be considered a substitute for the advice of a qualified medical professional, who should always be consulted before beginning any new diet or other health program. Detox the World (Natalia Rose Institute) disclaims any liability for any adverse effects arising from the use or application of the information contained herein. The information received should not be seen as medical or nursing advice and is certainly not meant to take the place of your seeing licensed health professionals.

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