Some people are told they must get a specific vaccine for a job. Parents are often told they must give vaccines to their children. This is a specific strategy[1] for when your doctor, employer, school, or others are pushing you to accept vaccines:

Tell you what, I’ll re-consider accepting your vaccines if you’ll sign this form to insure us against the risks. We both know there are risks involved with vaccines. In 2011 the Supreme Court ruled that vaccines were unavoidably unsafe. Your policy is seeking to force me to accept vaccines. Currently our family will carry the sole responsibility for any harm that is caused. So, if you really want me to consider vaccines, and if you are confident the risk is so low, then you should be willing to sign this document of insurance for me, accepting liability in the case of a vaccine reaction.

Here is the 6 page downloadable document

Vaccination Notice [.doc version]

Vaccination-Notice [.pdf version]

In this form there is space for many different parties to sign and agree to accept responsibility for the potential harm of the vaccine, including the manufacturer, government agencies requiring it, administrative office, actual administrator of the injections.

This document has 23 points which outlines the known harm of vaccines, the concept of informed consent, among other points.

While the possibility of getting the required signatures is extremely small, by NOT signing the document, there are consequences built in:

Refusal to sign this form is indication of deceit, bad faith and hypocrisy on the part of a vaccine administrator who may recommend vaccination as “safe”, but, at the same time, deny responsibility for the hazards. If vaccinations are “safe” then refusal or hesitation to sign this form is firm indication of misrepresentation with the assertion of “safety”.

NOTICE: If this form is refused or not signed by all vaccine administrators then refusal of vaccine is rightful and refusal must be presumed and honored. Vaccination does pose risks, therefore administration of vaccine without signature on this agreement by all parties called for herein or and/or without fully informed consent by all interested parties constitutes criminal assault, malpractice, intentional harm and violation of rights against the vaccinated parties and all other parties of common interest by the administrators and providers of the vaccine whether any harm is caused or not by the vaccination, therefore, without fully informed consent by all interested parties, major obligations arise from non-consensual vaccination whether or not the vaccination causes physical injury or disease.

NOTICE: Refusal to sign this form constitutes admission and warning to the prospective recipient of vaccination that vaccination may cause harm and should be avoided in order to protect the health and safety of those receiving treatment. This is separate and distinct from any benefit/s or “necessities” that may be attributed to vaccinations and vaccination programs.

[1] I give credit to http://freedomtaker.com for the majority of this form and strategy for giving vaccination notice.

Becky Hastings, wife to John for 36 years, mother of five naturally born breastfed babies, grandmother of six, passionate follower of Jesus and truth. As a volunteer breastfeeding counselor since 1993, Becky is devoted to helping parents, especially mothers, make wise decisions for the long-term health and wellbeing of their babies.