Vaccination Notice for Schools and Colleges


All states in the UNITED STATES have now passed statutes requiring that students receive certain vaccinations prior to admission. Some colleges and universities have taken it upon themselves to establish ‘vaccination requirements’ as well.  None of this has been done by popular vote, in other words we had no say in this matter.

The Vaccination Notice is designed to notify the school that you do not choose to have your son, daughter or self vaccinated with products the manufacturer doesn’t stand behind and you refuse to accept the liability for any vaccine injury or illness that might occur from the vaccinations.  It states clearly that if the school wishes to accept the liability you will reconsider your position. They will never accept the liability in writing, you can be sure. No one can force you to have toxic substances injected into you or your child while they remain immune from the damage that might ensue.


  • Download the LAWFULLY YOURS pdf guide posted on this page (Vaccination Notices are in Section 5), and the Word Doc templates for Vaccination Notices are linked right below it. Select the one(s) you wish to use.
  • Items in grey need to be personalized
  • Select son, daughter or self as applicable
  • Corporate entities need to be in all caps
  • The health department of each state is listed in its corporate name on the Dun and Bradstreet website
  • Sign the notice in red ink and obtain the signatures of two witnesses or one notary

It is essential to read, understand and agree with the notice before you sign and deliver it.


The notice requires little discussion. Just hand it to the clerk responsible for the collection of student paperwork. Explain that it is a lawful notice to be placed in your (or your child’s) record.  Should you be asked where you obtained the notice, simply say from another parent, which is true. Giving more information is not required nor recommended. Citing websites or vaccine aware groups or authors just serves to motivate those in the vaccination-distribution-business to track down and discredit (or worse) the folks that are doing their best to bring good information to the public. The less said the better. Let the notice speak for you.

Should the clerk refuse, politely remind him/her that that decision is not his/hers to make as the notice is for both the “agent” and the “principal”. You may have to remind the employee that neither the clerk nor his/her supervisor can make decisions for the “principal”. Keep a copy of the notice for yourself. Always always always remain polite.

Should the school employee refuse to place the notice in the record, write on the Vaccination Notice “refused by agent (name) on (date)” in the space at the top of the notice. Then take it home and send it certified mail (with return receipt) to the Superintendent (or Dean of Admissions). Include a short explanatory letter. Sample letters are included in the templates.

More methods of empowering yourself in our commercial (UCC) legal system can be found in the LAWFULLY YOURS guide.

38 responses to “Vaccination Notice for Schools and Colleges

  1. Excellent information. i, have studied law for three (years) and my recommendation is Parents write their own affidavits, refusal etc.,, &c. “UCC” is copyrighted, “Crown / Vatican canon law”. Parents, should write their own law. The reason it is suggested one “SIGNS” (proper word is autograph) in red ink is because red ink denotes you are on the land. Not in the sea and subject to Admiralty Maritime Merchant law (Commercial law (s)


  2. You do know that this is total bullshit, and it will mean nothing to those who want to call you idiots down for being so ignorant of the law. Pro and mandatory vaccination laws were passed by popular vote, or they would not have passed at all. Clearly, you also do not understand how laws are passed. Funny.

    In the meanwhile, good luck with this. You’ll need it!


  3. Oh, and know this idiocy has been fowarded to the Attorney General’s Offices for every state, the state public health departments, and the state education associations.

    Good luck!


  4. Melissa, unfortunately they were not passed by popular vote. Parents weren’t given a choice.


  5. hi, I’m filling out the vaccination notice but I need my state’s info for 5 and 8. I just put STATE OF CALIFORNIA AND CALIFORNIA DEPARTMENT OF HEALTH but noticed that it’s not the CDC they refer to but the DCDC

    The Division of Communicable Disease Control (DCDC)
    should I change this on numbers 3,4,11…. does that mean I need to change the state info on number 4 as well… wondering if the name was recently changed..


  6. Thank you so much for this information. I am going to start filling out this form today.


  7. Prisyla Aguayo

    Hi I need help with filling it the correct names for my state which is Florida. I do not want my child to be vaccinated and would like to provide this form to doctors and also to allow them to attend school.


  8. What’s the difference between signing their form and basically telling them no by submitting this form. Won’t we still be looked at as “harming” our children? My son has only had one round of shots minus hep b & dtap & he’s 8 months now. I’m in NY & it says on the form that we can only be excused for religious reasons. Will the letter trump that form?


  9. I did not see a notice. Can I have a link. I signed a form for religious exemption. But it didn’t have any extensive wording it was a simple one page thing. Should I recind it or look at it again? The school nurse witnessed it.
    Thank you


  10. Daycares/preschools here in Arizona accept your children if you sign the religious belief exemption, but i don not conccurre nor agree with any of the information stated on there. Should they accept the notice? Thank you


  11. I cannot locate the Vaccination Notice for CO…when I click on the link I get a list of text but no form/template. With bad advice and against my better judgement I just signed the new exemption forms. I did also send in the opt-out to the state tracking system but I want to revoke what I signed and submit a form that adheres to state law and does not cause me to lie and/or self-incriminate. Help?


  12. I just delivered the completed vaccination notice to my sons school here in CA. So far so good. Very grateful to have a sympathetic vice principal at his Jr high school. It may alleviate too much questioning. The health nurse is out today. Will find out tomorrow if i have to send notice to the superintendent it not. The good news is that my son is in school today after missing yesterday as a result of this unconstitutional law. Thank you so much for helping me to be a good patent. Your information is a God send. Will keep you updated.


    • Thank you so much for your feedback.

      Let’s not forget that the legal notice decision cannot be made by the school nurse who has no legal expertise or authority. If she claims she cannot accept it, smile at her and tell her it is a legitimate legal document that her superiors will have to review. Be polite but persistent. Remember her job depends on her following and enforcing certain rules and she is not told more than she needs to know.

      If you wish to email me directly, my email address is

      Best of luck.


  13. Thank you very much Al. I have sent you an email. In the meantime, can anyone clarify for me who the “principal” is? The school vice principal is the agent. Who is ultimately the principal? The CALIFORNIA DEPARTMENT OF HEALTH? The superintendent of our school district? THE STATE OF CALIFORNIA? I apologize if this is a novice question. Thank you for any help you can provide.


  14. i have concerns about cps getting involved, is that a usual response from the corporation that receives said notice?


    • If you look closely at the Vaccination Notice you will notice that it is a conditional agreement upon proof that the vaccination requester accept liability for harm or injury. Of course, we know they will never do that. You can always inform CPS that you are waiting for a response.


  15. Felicia Ferrell

    I need the for for GA. Can you please send me a link so I can make copies?


  16. What if the doctor wants you to sign the paper that you are refusing to vaccinate. How do we respond to that if we do not want to sign?


  17. I cant seem to find the health department corporation name on Dun and Bradstreet website.


  18. I live in Florida. Although not required for exemption, I planned to send a notarized religious exemption, non-consenting letter to the health dept and to sign the state religious exemption form. The form does not have anything deceivable to check. Since Florida only has a religious exemption, would you suggest that be done first? Then, if I have any problems, I could send the Vaccination Notice to the school administrator. I’m afraid that if I don’t go through the health dept (which they require) then it won’t be legit. Please help. Thanks!


  19. I’m trying to protect my children from receiving any more mandated vaccines to attend school. My daughter attends 7th grade next year, and the dTaP is required for her to enter 7th grade. As mentioned before, FL only has religious exemption, which is why I planned to send religious/non-consenting letter to health dept. Then I saw your site about the vaccination notice. I’m terrified to fight the system, but even more terrified to let my kids have any more vaccines.


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