To claim a religious exemption from school vaccines in Clark County, complete the Nevada Religious Immunization Exemption Certificate, check the vaccines your beliefs prohibit, initial the four acknowledgment statements, sign and date it, and hand-deliver it to your child’s school. The CCSD religious immunization exemption form is the same state-issued certificate used across Nevada, and NRS 392.437 bars any public school from refusing to enroll a child whose parent has filed a written statement that their religious belief prohibits immunization.1Nevada Legislature. Nevada Code 392.437 – Immunization of Pupils: Exemption if Prohibited by Religious Belief The form must be filed annually.
Where to Get the Form
CCSD hosts a downloadable version of the Religious Immunization Exemption Certificate on its website, in English and Spanish.2Clark County School District. Health Resources – South CTA The Nevada Division of Public and Behavioral Health and the Southern Nevada Health District publish the same certificate.3Nevada Department of Health and Human Services. Preschool-12th Grade Religious Immunization Exemption Certificate All three versions are identical. If you cannot print at home, the front office or registrar at your child’s school can hand you a blank copy.
Filling Out the Form
The certificate has three sections. You complete the first two. School staff complete the third after you submit it.4Southern Nevada Health District. Religious Immunization Exemption Certificate
Section 1: School and Student Information
Enter the name of the school accepting the exemption, with its street address, city, zip code, and phone number. Below that, write your child’s full legal name, date of birth, and current grade. Confirm the school name matches the campus where your child is actually enrolled or registering. A form addressed to the wrong school can delay processing.
Section 2: Vaccine Selections, Initials, and Signature
The form lists checkboxes for DTaP, Hepatitis A, Hepatitis B, IPV, MenACWY, MMR, Td/Tdap, and Varicella.4Southern Nevada Health District. Religious Immunization Exemption Certificate Check every vaccine you are declining. You can check all of them or only the specific ones your beliefs prohibit; selecting a subset is acceptable if your objection applies to certain ingredients or vaccine types but not others.
Below the checkboxes are four acknowledgment statements, each with its own initials line. You must initial all four:
- You understand the risks of refusing vaccination and that you may revisit the decision and complete the vaccinations at any time.
- You understand the risk of your child contracting the disease the vaccine prevents.
- You understand the risk of your child transmitting that disease to others.
- You understand the form must be submitted annually on the enrollment schedule set by the school district.
A missing set of initials is one of the most common reasons a form gets sent back. After initialing, sign and date the bottom of the section. If your child is 18 or older, the student signs instead of the parent or guardian.3Nevada Department of Health and Human Services. Preschool-12th Grade Religious Immunization Exemption Certificate No notarization is required.
Section 3: School Official Use Only
Leave this section blank. It holds signature and date lines for the school nurse and a school board representative, who sign after reviewing your completed form.
What Counts as a Religious Belief
NRS 392.437 requires only that the written statement indicate your “religious belief prohibits immunization.”1Nevada Legislature. Nevada Code 392.437 – Immunization of Pupils: Exemption if Prohibited by Religious Belief The statute does not define the term further, and it does not require membership in any particular church or denomination. The form itself does not ask you to name your religion or explain your theology. You check the vaccines, initial the acknowledgments, and sign.
The belief does need to be religious in nature. Under broader federal standards, religious beliefs include individualistic and unconventional convictions held with the strength of traditional religious views, but political, social, or purely philosophical objections do not qualify. A general preference to avoid vaccines, or concerns rooted solely in medical safety research, would not meet the statutory standard.
Submitting the Form
Bring the completed form to the front office or registrar at your child’s school. CCSD directs parents to deliver all required documents, including exemption forms, in person at the child’s zoned school.5Clark County School District. Enroll in Clark County School District Hand-delivering lets you confirm on the spot that the registrar has it and that no fields were left blank. Ask for a date-stamped copy or a written receipt for your records.
The school nurse and a school board representative review and sign Section 3 once they confirm the form is complete. CCSD does not publish a specific processing timeline. If anything is missing, such as an unsigned line or a skipped set of initials, the school will contact you using the information on file to request corrections before the exemption can be recorded.
Renewing the Exemption Each Year
The exemption is not permanent. The form states that it “must be submitted annually based on an enrollment schedule set by the school district, charter school or private school.”4Southern Nevada Health District. Religious Immunization Exemption Certificate CCSD confirms this on its enrollment page.5Clark County School District. Enroll in Clark County School District File a new form each school year during the enrollment or registration window. If you do not submit a renewed form when the district requests one, your child’s immunization record will show a gap, and the school can exclude the student until the paperwork is current.
When the Exemption Won’t Keep Your Child in Class
A religious exemption does not guarantee uninterrupted attendance during a disease outbreak. Under NRS 392.446, whenever the State Board of Health or a local board of health determines that a dangerous contagious disease exists at a school attended by an exempt child, the school board must either see the child immunized or keep the child home until the outbreak is resolved and the local health officer is notified.6Nevada Legislature. Nevada Code NRS 392 – Pupils The acknowledgment you initial about the risk of transmission reflects this possibility. If an outbreak triggers exclusion, the school will notify you directly, and your child returns once the health authority clears the campus.