Swine Flu Rebuttal

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For the Attention of Head Teacher, Nurse and both of our son’s class teachers.

NOTICE OF UNDERSTANDING & REFUSAL OF CONSENT TO VACCINATE

We, Mum and Dad hereby formally state, on this date of 24th November 2009
that I, as legal parent, have chosen not to vaccinate, nor do We allow my
unauthorized, compulsory or mandated (school, city, county, state or
government) vaccination of either of our children: Childs name hereES OF
PARENTS HERE to Any & All forms of the:
N1H1 (A or B), H1N1, N1H5, H2N1, H3N2, AH3N2 - Influenza, Swine, Asian or
Avian Flu Vaccines, Under ANY Circumstances.
We maintain this decision under existing provisions for non-vaccination of
children whose parents object to vaccines for religious & or philosophical reasons
are legally allowed, violation of this, my right is both criminally & civilly liable.
Vaccinations of any kind is a medical procedure, and under such Laws, MY signed
parental authorization must be fully granted before any such procedure can be
initiated, implemented, forced or done without MY full parental authorization &
compliance.
We accept full responsibility for the health of our children, and because of my
philosophical & religious convictions, We hereby again reaffirm that We
Do NOT wish our children vaccinated under ANY circumstances.
In the event of any infectious condition, the perceived &/ or the qualified
diagnosis of such condition by a licensed health care professional (under my
direct knowledge or supervision)
I am to be immediately notified and our children will remain at home for the
duration of the condition. I further understand that during the course of an
outbreak of any “vaccine preventable disease” or similar case, which could or
would occur at your facility, Our children is subject to exclusion from your facility
for the duration of the outbreak or until deemed clear to return to your facility
(ie: school) by my family doctor.
This refusal form is NOT open to interpretation, bypass or refusal for legal
acceptance & acknowledgment by Anyone, School Administration, State or local
Authority or health care professional, be it presented in person via myself,
Natalie or via our children, both named above.

______________________________ ____________ Date

______________________________ ____________ Date

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