School Vaccination Waiver Sample

Your Name
Your Address
Your Contact Phone

Date

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.

Sincerely,

Your Name