Immunization Exemption Letter
May 12, 2009
To Whom It May Concern:
Re: Religious Exemption, CHILD NAME
We, XXXX (Parents names), being the legal guardians of XXXXX, object to the vaccination requirements as outlined by the Department of Health of the Commonwealth of Pennsylvania as defined by 27.PA.CODE CH. 77 on the basis of a strong moral or ethical conviction similar to a religious belief as outlined in section §23.84 Exemption from immunization. On that basis, XXXXX will receive no further vaccinations.
This is what I just used for daycare and they had no issue with it.