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2019-2020 Louisiana 4-H Youth Development Program Statement of Exemption from Immunization-2026
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How to use or fill out 2019-2020 Louisiana 4-H Youth Development Program Statement of Exemption from Immunization
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name as the parent or guardian in the designated field. This is crucial for identifying who is claiming the exemption.
- Next, provide your child's full name and date of birth in the respective fields. Accurate information here ensures proper processing of the exemption request.
- Indicate your reason for exemption by checking either 'Medical' or 'Religious/Philosophical'. If you select 'Medical', remember to attach a note from your healthcare provider.
- Fill in the name of your 4-H club and parish in the specified area to link your request with the appropriate local organization.
- Finally, sign and date the form at the bottom. This confirms your request and understanding of potential exclusion during outbreaks.
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