Illinois Certificate of Religious Exemption for Immunizations
This form is used to request a religious exemption for required immunizations and examinations for students. Parents or guardians must complete the form for children entering kindergarten, sixth, or ninth grades. A separate form is required for each child enrolled in any school.
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How do I fill this out?
Filling out the Certificate of Religious Exemption is simple. Begin by completing the parent/guardian section with necessary details about the student and the school. Don’t forget to provide a religious statement for each exemption requested.
How to fill out the Illinois Certificate of Religious Exemption for Immunizations?
1
Complete the Parent/Guardian section with student and school details.
2
State each vaccination and examination for which an exemption is requested.
3
Provide a detailed statement of religious beliefs for each request.
4
Ensure the form is signed by both the parent/guardian and healthcare provider.
5
Submit the form by the required deadline to the local school authority.
Who needs the Illinois Certificate of Religious Exemption for Immunizations?
1
Parents of students entering kindergarten who wish to waive immunization requirements.
2
Legal guardians seeking exemptions for children enrolling in grades six or nine.
3
Families wanting to ensure their religious beliefs are honored in school health policies.
4
Guardians of children in private or charter schools who need religious accommodation.
5
Individuals advocating for religious exemptions based on specific faith principles.
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1
Open the PDF document in PrintFriendly.
2
Use the editing tools to fill out the required fields accurately.
3
Provide the necessary religious statements for the exemptions requested.
4
Review your entries for any inaccuracies or needed changes.
5
Save your edited document for submission or sharing as needed.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include: October 16, 2015, when the use of the Certificate of Religious Exemption became mandatory for certain grades. For the 2024-2025 school year, ensure to submit completed forms by October 15 or as required by your school district's enrollment policy.
What is the purpose of this form?
The purpose of the Certificate of Religious Exemption is to provide a legal means for parents and guardians to exempt their children from immunizations and school examinations on religious grounds. This document allows families to uphold their beliefs while complying with educational requirements. By filling out this form, they formally notify the school of their request for exemption based on their religious convictions.
Tell me about this form and its components and fields line-by-line.
- 1. Student Name: Enter the last, first, and middle names of the student.
- 2. Date of Birth: Provide the student's date of birth.
- 3. School Name: Indicate the name of the school the child will be attending.
- 4. City: Specify the city where the school is located.
- 5. Grade: List the grade level that the student will be entering.
- 6. Parent/Guardian Name: Fill in the name of the parent or legal guardian.
- 7. Address: Provide the current address of the parent or guardian.
- 8. Gender: Select the gender of the student.
- 9. Telephone Number: Input a contact number for the parent or guardian.
- 10. Exemption Requested: Mark the vaccinations and examinations for which exemptions are requested.
- 11. Religious Beliefs Statement: Detail the specific religious beliefs that prevent the vaccinations/examinations.
What happens if I fail to submit this form?
Failure to submit the form may result in the child being required to receive the necessary immunizations and examinations. This could ultimately hinder their ability to attend school as regulations require adherence to vaccination protocols for enrollment.
- Non-Compliance with State Regulations: Not submitting the form may lead to non-compliance with state health regulations, which could affect school enrollment.
- Health Risks: Parents might expose their children and the community to health risks related to preventable diseases.
- Exclusion from School Activities: In case of disease outbreaks, unvaccinated children may be excluded from school to safeguard public health.
How do I know when to use this form?
- 1. Entering Kindergarten: Use this form when your child is starting kindergarten and you wish to exempt them from vaccinations.
- 2. Transitioning to Sixth Grade: Necessary for students moving into sixth grade who need health examination exemptions.
- 3. Moving into Ninth Grade: Required for ninth graders who will receive religious exemptions from targeted immunizations.
- 4. Enrolling in Private School: Utilize this document to request religious exemptions for children entering private educational institutions.
- 5. Changing Schools: Required documentation for families transferring schools seeking exemptions.
Frequently Asked Questions
How do I apply for a religious exemption?
You need to complete the Certificate of Religious Exemption form and submit it to your local school authority.
Who needs to sign the form?
Both a parent or legal guardian and the child's healthcare provider must sign the form.
What information is needed on the form?
You'll need to provide details about the student, the school, and the specific vaccinations/examinations for which you're requesting exemption.
What happens if I don't submit this form?
Your child may be required to undergo the specified vaccinations or examinations to enroll in school.
Can I use this form for personal beliefs?
No, this form is intended solely for religious exemptions, not personal or philosophical reasons.
Is there a deadline for submission?
Yes, completed forms must be submitted by October 15th or the earlier enrollment date set by the school district.
Can I save the PDF on PrintFriendly?
While you can edit and download your PDF, saving directly on the site isn't currently supported.
What should I do if I need extra space on the form?
If additional space is required, please attach extra pages detailing your exemptions.
How do I share the completed PDF?
You can share it directly through print or email options available in PrintFriendly.
What if my child is in a private school?
The same form applies for claiming a religious exemption, regardless of the type of school.
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