Exemption from Child Care Vaccinations

The Child Care and Early Years Act requires that children attending any licensed child care facility or nursery school in Ontario be immunized against certain diseases or have a valid exemption on file at your child care centre and at Niagara Region Public Health.

If you choose to exempt your child from vaccinations for medical, religious or philosophical reasons, you need to submit a:

  • Statement of medical exemption, or
  • Statement of conscience or religious belief affidavit

There are things to keep in mind when you choose not to vaccinate your child.

Note: To avoid delay or having an incomplete form returned, read the following.

Statement of Medical Exemption

  • A medical exemption must be completed by your health care provider.
  • Niagara Region Public Health cannot legally accept a fax or photocopy of the exemption. If you require an original copy for your personal files, have your health care provider complete two exemptions.
  • Please be advised that if you move to another public health unit area at a future date, you may be required to complete another exemption at that time

Complete these steps:

  1. Download the form

    You can also call Niagara Region Public Health to have one mailed to you at
    905-688-8248 ext. 7425 or 1-888-505-6074

  2. Completed exemption forms can be mailed or delivered in person to:
  3. Main Office Location
    Niagara Region Public Health
    1815 Sir Isaac Brock Way, Campbell East, Thorold
    Monday - Friday from 8:30 a.m. - 4:30 p.m.

    Mailing Address
    Vaccine Preventable Disease Program
    c/o Niagara Region Public Health
    P.O. Box 1052, Station Main,
    Thorold, ON L2V 0A2

Statement of Conscience or Religious Beliefs Affidavit

  • The affidavit must be signed and stamped by a commissioner of oath, notary public or a justice of the peace
  • The Commissioner for Taking Affidavit must print their name (lawyers, print law society number), full address, telephone number, title and seal if available
  • Niagara Region Public Health cannot legally accept a fax or photocopy of the affidavit. If you require an original for your personal files, have the commissionaire complete two forms.
  • Please be advised that if you move to another public health unit area at a future date, you may be required to complete another Affidavit at that time

To exempt your child from vaccination for conscience or religious reasons, complete these steps:

  1. Fill-out and print the form

    You can also call Niagara Region Public Health to have one mailed to you at
    905-688-8248 ext. 7425 or 1-888-505-6074

  2. Have the affidavit signed and stamped by a commissioner of oaths
  3. Completed affidavits can be mailed or delivered in person to:
  4. Main Office Location
    Niagara Region Public Health
    1815 Sir Isaac Brock Way, Campbell East, Thorold
    Monday - Friday from 8:30 a.m. - 4:30 p.m.

    Mailing Address
    Vaccine Preventable Disease Program
    c/o Niagara Region Public Health
    P.O. Box 1052, Station Main,
    Thorold, ON L2V 0A2

Commissioner of Oaths

A Commissioner of Oath is a person authorized to take your oath or solemn affirmation when you sign an affidavit or a statutory declaration.

  • Commissioners of Oaths are: Regional Clerk or Deputy Regional Clerk; City Clerk or Deputy Clerk; Treasurers or Deputy Treasurers of municipalities; Justices of the Peace (for items of a legal nature); Lawyers; MP; MPP; Licensed Paralegals; Police Chiefs; some staff at the Service Ontario, Government Information Centre are Commissioners
  • Some Commissioners will provide the service at no cost, others may charge a fee
  • Multiple pieces of photo ID may also be required

The client should call to confirm the times that this service is available, if there is a cost before going and if an appointment is necessary.

Municipal OfficeAddressPhone Number
Fort Erie1 Municipal Centre Dr.905-871-1600
Grimsby160 Livingston Ave.905-945-9634
Lincoln4800 South Service Rd.905-563-8205
Niagara Falls4310 Queen St.905-356-7521
Niagara-on-the-Lake1593 Four Mile Creek Rd.905-468-3266
Pelham20 Pelham Town Square905-893-2607
Port Colborne66 Charlotte St.905-835-2900
St. Catharines50 Church St.905-688-4889
Thorold3540 Schmon Pky.905-227-6206
Wainfleet31940 Highway #3905-899-3463
Welland60 East Main St.905-735-1700
West Lincoln318 Canborough St.905-957-3346
Niagara RegionSir Isaac Brock Way905-980-6000

During an Outbreak

In the event of an outbreak of a vaccine preventable disease, your child will be excluded from attending child care for the duration of the outbreak.


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