With everything going on we wanted to share a few exemption form templates that you can use for inspiration if you are finding yourself in the position of needing a Religious Vaccine Exemption.

Please remember that this information is provide for education purposes only and does not constitute any legal or medical health advice. 

Make sure to check to see what your state’s specific vaccine exemption laws are, so you know how to proceed.

Many states also have advocacy health freedom groups in many states. Do an internet search for your state plus vaccine freedom, or health freedom.

https://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx

There are a few websites that have already put some great information together. Please remember that these vaccine exemption templates are to help give you an idea of where to start. Check your state guidelines, as well as making sure it reflects your true and honest personal religious beliefs.

We will not get into medical exemptions as you need to work closely with your trusted medical care provider to get a legitimate medical vaccine exemption. 

For Christian religious vaccine exemptions the following websites have some example vaccine exemption forms to give you some good ideas.
This is not an all-inclusive list. You can do an internet search for more websites and information.

 

Remember, that these samples should be updated to reflect your actual personal religious beliefs, even if they are not Christian beliefs. You could be Jewish, Catholic, Buddhist, Wiccan, Satanist, Athiest, Heathen, Pagan or any number of other personal religious, or non-religious, beliefs that you may hold either in a group, or your own personal beliefs by yourself.

https://awakenny.wordpress.com/2021/06/26/how-to-write-a-religious-exemption-letter/

https://healthfreedomidaho.org/sample-letter-for-religious-vaccine-exemption/

https://apologiachurch.com/wp-content/uploads/2021/09/Medical-Statement.pdf

https://gccto.regfox.com/general-religious-exemption-letter

 

This link is a clergy religious exemption letter sample that you can adapt to your personal information and situation.
(Or scroll down to see the full text at the bottom of this page.)

https://www.facebook.com/RainbowCPC/posts/1923653117802125

 

This site not only has a Christian Religious Vaccine Exemption letter, but also has a template that Active Duty Service Members can use to file a Religious exemption from the mandated COVID Vaccine.

https://fredbrownbill.wordpress.com/2021/07/31/important-download-covid-vaccine-religious-exemption-documents-here/

The Pentagon released the religious exemption guidelines for bypassing the mandatory vaccine. Service members who want a vaccine exemption will be required to seek counseling regarding their decision. So talk to your command and see if they already have a vaccine exemption form available, or you can use the sample at the link directly above.

Read more about it at the link below….

https://www.foxnews.com/politics/pentagon-releases-religious-exemption-guidelines-for-bypassing-mandatory-vaccine

 

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For those that may follow a more earth-based religious belief, I have crafted a sample religious vaccine exemption below that could be adapted for Wiccans, Witches, Druids or any other Earth based religious beliefs.

Date:

To Whom It May Concern:
RE: Requesting Immunization Exemption based on Religious Beliefs

I, (YOUR NAME), find it against my current and deeply held personal religious beliefs to be vaccinated, or immunized, against COVID or any other virus through any modern pharmacological means.

My personal religious beliefs are that our bodies have the ability to heal naturally, or with support only from the healing power of the earth and organic, earth-based natural substances, proper nutrition and foods used to support a robust natural immune system.

My deeply held personal religious beliefs also refrain me from participating in any practice, lifestyle, ingestion or injection that could possibly cause harm to, or introduce foreign substances into my body.

In addition to protection in Title 2 in the Civil Rights Act, U.S. Code 42§§ 2000 (a), recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon “personal” religious beliefs. (Sherr and Levy vs. Northport East-Northport Union Free School District, 672 F. Supp. 81, (E.D.N.Y., 1987); (Allanson vs. Clinton Central School District, U.S. District Court, Northern District Court, Northern District of New York (84 CV 174), 1984; Campain vs. Marlboro Central School District, Supreme Court Ulster County Special Term, November 15, 1985; Brown vs. City School District, 429 NYS2d 355; Maier vs. Besser, 73 Misc.2d 241).

I am exercising my right under the First Amendment of the US Constitution and §C.R.S. 25-4-1704 (4) (b) to receive Religious Exemption from vaccinations. Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Thank you in advance for your anticipated cooperation with this request.

Signature:_____________________________________ Date:____________

State of ________________________ County of ______________________
On this day, personally appeared before me ______________________________,
to me known to be the person described in and who executed the within and foregoing instrument, and acknowledged that he/she signed the same as his/her voluntary act and deed, for the uses and purposes therein mentioned.
_______________________________
(Notary Public)
My Commission Expires: ____________________

 

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Full text for the clergy religious exemption letter for an employer sample provided by Rainbow Community Praise Center

SAMPLE RELIGIOUS EXEMPTION LETTER

This a sample letter written by Dr. Isaac Olutunji for those seeking to craft a RELIGIOUS EXEMPTION for their employer who is mandating the Covid vaccine.

Project Latter Rain
Religious Liberty Advocacy Services
Box 30033
7000 Adventist Blvd. N.W.
Huntsville, AL 35896
256.457.9741

Date:
To Whom It May Concern:
RE: Requesting Immunization Exemption for based on Religious Beliefs

I am writing this letter on behalf of _____ who has requested this letter of recommendation from me as a religious leader for exemption from Covid-19 immunization for religious reasons. Seventh-day Adventists believe in religious liberty and liberty of conscience in their duty to God as one of our denominational tenets regarding our 1st amendment right of freedom of religion which protects them against mandates that prohibits their liberty to exercise their religion which espouses force in any manner. Adventists according to their fundamental belief #21 “Stewardship” (See Adventist.org/beliefs/) believes that the “…body is the temple of God” (1 Corinthians 6:19) which leads them to take care of their bodies as a steward of God’s temple by health and immune building lifestyle practices and also refraining from any practice, lifestyle or ingestion that could possibly harm their bodies. With reports in the mainstream media of negative side-affects (death included) in a number of Covid-19 vaccine cases causes the recipient of this letter hesitancy regarding this vaccine as safe for their health which according to their personal religious belief is their sacred duty to God.

In addition to protection in Title 2 in the Civil Rights Act, U.S. Code 42§§ 2000 (a), recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon “personal” religious beliefs. (Sherr and Levy vs. Northport East-Northport Union Free School District, 672 F. Supp. 81, (E.D.N.Y., 1987); (Allanson vs. Clinton Central School District, U.S. District Court, Northern District Court, Northern District of New York (84 CV 174), 1984; Campain vs. Marlboro Central School District, Supreme Court Ulster County Special Term, November 15, 1985; Brown vs. City School District, 429 NYS2d 355; Maier vs. Besser, 73 Misc.2d 241).
Mr./Ms. ____ is exercising their right under the First Amendment of the US Constitution and §C.R.S. 25-4-1704 (4) (b) to receive Religious Exemption from vaccinations. Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion. I am confident that you will be able to arrange a suitable accommodation for Mr./Ms. _____ and that when you do so, you will secure their loyalty and dedication to be the best employee they can be. His/Her respect for God’s authority that leads him/her to be in respect for the best interests of your company and giving their very best service at work. Thank you in advance for your anticipated cooperation with this request.

Sincerely,
Isaac Olatunji Jr., M.Div., PhD
Ordained Minister
Religious Liberty Advocate and Consultant
Huntsville, AL
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NOTICE: Feel free to use this letter. Yes, However, if you desire a letter that is written more specifically for your circumstances (e.g., county, state, company, etc.), I have been providing that service for many, especially since the Pfizer FDA approval. The letter addresses the most current Covid research and cites (hyperlink references) the First Amendment, EEOC, Belmont Report, CDC, FDA, state, and the Bible-non sectarian).
Items needed to construct the letter are as follows: (1) Your name, (2) Number of years on the job, (3) Org County, (4) Addressee (person, title), (5) Org name, (6) Org address, (7) Number of years on this job.
Please let me know if I can be helpful to you.
Warm Regards,

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