Immunization Exemption Form - Members - Young Marines 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Young Marine's information, including their last name, first name, middle initial, and date of birth in the designated fields.
3. In the Immunization Exemption Request section, acknowledge your child's exemption by selecting the appropriate grounds (religious, philosophical, or medical) and listing the specific vaccines for which you are requesting an exemption.
4. Fill out the Primary Emergency Contact details accurately, including their printed name, home phone number, cell phone number, and email address.
5. Complete the Parent/Legal Guardian Affirmation section by providing your printed name, signature, and date. If there are two guardians, ensure both sign where indicated.

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