Living a Good Life Church Inc.
Religious Exemption
To Whom It May Concern:
I, , wish to assert my constitutionally protected right of association with Living a Good Life Church; my sincerely held belief in its formal doctrine and discipline, to assert a claim of religious exemption from involuntary vaccination based on my adherence to its creed.
Printed Name
Signature
Date
Phone
Mailing Address
Reference: Living a Good Life Church Inc. EIN: 87-0863845 – Idaho Registered Nonprofit Corporation – Mailing Address: 6 Elm Street #931 Bridgton, ME 04009