Commonwealth of Virginia Certificate of Religious Exemption
This form is used to document a religious exemption from immunizations for students in Virginia. Parents or guardians may fill this out if immunizations conflict with their religious beliefs. The form requires notarization and provides necessary legal protection for your child.
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How do I fill this out?
To fill out the Certificate of Religious Exemption, gather the required personal information for the student. Next, indicate the religious conflict with immunizations clearly in the appropriate section. Finally, ensure the form is signed by a notary public to validate your exemption.

How to fill out the Commonwealth of Virginia Certificate of Religious Exemption?
1
Gather the student's personal information including name and date of birth.
2
Clearly indicate the conflict with immunizations in the designated section.
3
Sign the form in the presence of a notary public.
4
Submit the completed form to the appropriate school authority.
5
Retain a copy of the form for your personal records.
Who needs the Commonwealth of Virginia Certificate of Religious Exemption?
1
Parents seeking to exempt their child from immunizations for religious reasons.
2
Guardians of students in Virginia who adhere to specific religious beliefs.
3
Schools requiring documentation for immunization exemptions.
4
Legal representatives assisting families with school enrollment.
5
Health officials needing records of immunization exemptions.
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What are the instructions for submitting this form?
To submit the Certificate of Religious Exemption, first ensure it is fully completed and notarized. You can submit it to your child’s school office either in-person or via fax. If online submission is available in your district, follow the guidelines provided by your school district for digital submission. Ensure you keep a copy for your records.
What are the important dates for this form in 2024 and 2025?
Important submission dates for the Certificate of Religious Exemption typically coincide with the start of the school year each fall. Ensure your form is completed and submitted to your child's school by the assigned deadline, often within the first few weeks of the academic year. Staying informed on school enrollment deadlines is crucial to avoid disruptions in your child's education.

What is the purpose of this form?
The purpose of the Commonwealth of Virginia's Certificate of Religious Exemption is to formally exempt students from receiving vaccinations. This form allows parents or guardians to declare that immunizations conflict with their religious beliefs, providing legal documentation needed in educational settings. By obtaining this exemption, families can ensure their children’s right to an education while adhering to personal and family beliefs.

Tell me about this form and its components and fields line-by-line.

- 1. Name of Student: The full name of the student applying for the exemption.
- 2. Date of Birth: The birth date of the student, formatted as MM/DD/YYYY.
- 3. Student I.D. Number: A unique identification number assigned to the student.
- 4. Signature: The signature of the parent, guardian, or student validating the form.
- 5. Date: The date when the form is signed.
What happens if I fail to submit this form?
Failing to submit this form may lead to vaccination requirements for your child. Schools in Virginia subject to health regulations will enforce policies regarding immunization compliance. Consequently, your child may face exclusion from attendance until the immunization is performed or the exemption is granted.
- Vaccination Requirement: Without the form, the school may require your child to receive vaccinations to attend.
- Possible Exclusion: Noncompliance can lead to your child being excluded from school until requirements are met.
- Legal Compliance: You may need this document to ensure adherence to state laws.
How do I know when to use this form?

- 1. School Enrollment: To enroll your child in school without immunizations.
- 2. Religious Declaration: To officially declare religious beliefs against vaccination.
- 3. Health Compliance: To comply with state health regulations regarding school attendance.
Frequently Asked Questions
How do I access the Certificate of Religious Exemption?
You can find the form by searching on our website or through educational institutions in Virginia.
Can I edit the PDF after downloading?
Yes, you can use PrintFriendly to make edits before downloading your final version.
Is notarization required for this form?
Yes, the form must be notarized to ensure its validity.
What should I do after filling out the form?
Submit the completed form to your child's school and keep a copy for your records.
Can I share the form after editing?
Absolutely! You can easily share it via email or social media.
What happens if I don’t submit this form?
Your child may be required to receive vaccinations in order to enroll in school.
How do I know if my exemption is accepted?
Contact your child's school to confirm receipt and acceptance of the exemption form.
Where can I find more information about immunization requirements?
Check the Virginia Department of Health's website for comprehensive guidelines.
Is there any fee associated with notarization?
Notary fees can vary, so check with your local notary for pricing.
Can I use this form for other states?
This Certificate is specific to Virginia; please check with other states for their requirements.
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