It's not complicated. Print and complete this form; and provide copies to whomever it may concern. Keep original at home, on-file.
We are a completely non-vaccinating family. If one chooses to intentionally, selectively vaccinate, my understandig is that it is legally inauthentic to file a "religious exemption". However, it is illegal to complete a religious exemption based upon philosophical objection in NC.
Pat
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North Carolina Immunization Law
Religious Exemption
North Carolina General Statute 130A-157
SECTION 130A-157. Religious Exemption - If the bona fide religious beliefs of an adult or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements contained in this Part [Chapter 130A, Article 6, Part B], the adult or the child shall be exempt from the requirements. Upon submission of a written statement of the bona fide religious beliefs and opposition to the immunization requirements, the person may attend the college, university, school or facility without presenting a certificate of immunization.
Pursuant to the aforementioned N.C.G.S. 130A-157, I, the undersigned, declare the immunization requirements as set for the in N.C.G.S. 130A-157 contrary to my bona fide religious beliefs and request, as permitted by the law, an exemption from the immunization requirements of your institution for myself or the undersigned minor child under my legal care or guardianship.
NAME __________________________________________________ __
SIGNATURE _______________________________________________
ADDRESS _________________________________________________
_________________________________________________
PHONE_________________________________________________
DATE_________________________________________________
____ Check here if declaring exemption for a minor child and enter child's name below
MINOR CHILD'S NAME _______________________________________________
MINOR CHILD'S NAME _______________________________________________