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South Dakota Religious Exemption Form
Polio Hepatitis B Smallpox Measles Other TB test Mumps Rubella Haemophilus influenzae type b Varicella Anthrax This is pursuant to my right to refuse vaccination on the grounds that vaccinations conflict with to our child s school administrator or operator of the group program pursuant to South Dakota Statues. 13-28-7. 1 2 Parent Date Subscribed and Sworn before me this day of 20. Notary s Signature and Seal Making Informed Decisions Your decision to vaccinate or not should be an informed...
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