A religious exemption pursuant to SDCL 13-28-7.1 requires the signature of the parent or guardian on the South Dakota Department of Health - Certificate of Immunization form or a signed statement by the parent or guardian stating that child is adherent to a religious doctrine whose teachings are opposed to immunization.

Any child entering school or an early childhood program in this state, shall, prior to admission, be required to present to the appropriate school authorities certification from a licensed physician that the child has received or is in the processof receiving adequate immunization against poliomyelitis, diphtheria, pertussis, rubeola, rubella, mumps, tetanus, meningitis, and varicella, according to recommendations provided by the Department of Health. The Department of Health may modify or delete any of the required immunizations. As an alternative to the requirement for a physician's certification, the child may present:

• (1) Certification from a licensed physician stating the physical condition of the child would be such that immunization would endanger the child's life or health; or
• (2) A written statement signed by one parent or guardian that the child is an adherent to a religious doctrine whose teachings are opposed to such immunization.

Any student entering a public or private postsecondary education institution in this state for the first time after July 1, 2008, shall, within forty-five days after the start of classes, present to the appropriate institution certification from a licensed physician that the student has received or is in the process of receiving the required two doses of immunization against measles, rubella, and mumps. As an alternative to the requirement for a physician's certification, the student may present:

• (1) Certification from a licensed physician stating the physical condition of the student would be such that immunization would endanger the student's life or health;
• (2) Certification from a licensed physician stating the student has experienced the natural disease against which the immunization protects;
• (3) Confirmation from a laboratory of the presence of adequate immunity; or
• (4) A written statement signed by the student that the student is an adherent to a religious doctrine whose teachings are opposed to such immunizations. If the student is under the age of eighteen, the written statement shall be signed by one parent or guardian.