Montana Affidavit of Exemption on Religious Grounds
This form allows students in Montana to claim an exemption from mandatory vaccinations on religious grounds. It must be completed and signed by a parent or guardian if the student is under 18. Ensure all required fields are filled out accurately to avoid processing delays.
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How do I fill this out?
To fill out this affidavit, start by entering the student's full name and relevant contact information. Next, indicate which vaccinations the exemption applies to by checking the appropriate boxes. Finally, ensure that a parent or guardian signs the document if the student is under 18.
How to fill out the Montana Affidavit of Exemption on Religious Grounds?
1
Enter the student's full name, date of birth, and age.
2
Provide the contact details of the parent or guardian if applicable.
3
Select the vaccinations for which exemption is requested.
4
Sign the form where indicated.
5
Submit the completed form to the appropriate school authority.
Who needs the Montana Affidavit of Exemption on Religious Grounds?
1
Parents of school-aged children seeking a religious exemption.
2
Students who wish to remain unvaccinated for specific religious beliefs.
3
Guardians responsible for minors in educational institutions.
4
Religious organizations guiding their members on such exemptions.
5
Legal guardians seeking to navigate vaccination requirements on behalf of a child.
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What are the instructions for submitting this form?
To submit the completed Affidavit of Exemption, please provide it to your child's school administration office. You can also contact the Montana Department of Public Health & Human Services at (406) 444-5580 for more guidance. Ensure that the signed form includes all necessary details for proper processing.
What are the important dates for this form in 2024 and 2025?
The important dates for the upcoming school years include: August 15, 2024: Submission deadline for Fall enrollment, August 15, 2025: Submission deadline for Fall enrollment.
What is the purpose of this form?
The Affidavit of Exemption on Religious Grounds allows parents or guardians to opt out of mandated vaccinations for their children based on religious beliefs. This form is a legal document that provides a mechanism for families to uphold their personal convictions while participating in the school system. Ensuring that the process is transparent and accessible is crucial for maintaining trust within the community.
Tell me about this form and its components and fields line-by-line.
- 1. Student's Full Name: The complete name of the student requesting the exemption.
- 2. Birth Date: The date of birth of the student.
- 3. Age: Current age of the student.
- 4. Sex: Gender of the student.
- 5. School: The name of the school the student attends.
- 6. Parent/Guardian Name: Name of the parent or guardian if the student is under 18.
- 7. Street Address and City: Residential address where the student resides.
- 8. Telephone: Contact number for the parent or guardian.
- 9. Vaccinations Exempted: List of vaccinations against which the exemption is claimed.
- 10. Signature: Signature of the parent, guardian, or student.
- 11. Date: Date when the affidavit is signed.
- 12. Notary Public: Signature and seal of the notary public.
What happens if I fail to submit this form?
Failing to submit this form on time could result in the student being excluded from school during outbreaks of the diseases listed. It is important to keep this documentation current to avoid interruptions in education.
- Exclusion from School: Students may be excluded from attending school if the form is not submitted or accepted.
- Legal Consequences: Incomplete or incorrectly filled forms may lead to legal repercussions for guardians.
- Health Risks: Students without vaccinations during outbreaks may pose health risks to themselves and others.
How do I know when to use this form?
- 1. School Enrollment: When enrolling a child in school, this form is necessary for exemption.
- 2. Vaccine Requirements: To meet specific vaccination requirements while maintaining religious beliefs.
- 3. Outbreak Situations: To provide necessary documentation during outbreaks to avoid exclusion.
Frequently Asked Questions
Who is eligible to fill out this form?
This form can be filled out by parents or guardians of children attending Montana schools.
What vaccinations can be exempted?
You can claim exemptions for Diphtheria, Pertussis, Tetanus, Polio, Measles, Mumps, Rubella, Varicella, and Hib.
How do I submit the completed form?
Once filled, submit the form to your child's school administration.
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Do I need a notary for the signature?
Yes, a notary public must witness the signing of the document.
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Can I save my edited document directly on the site?
You can download your edited document to your device for personal use.
What should I do if I have questions about the form?
Contact the Montana Department of Immunizations for assistance with any queries regarding the affidavit.
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