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Liability Letter (PDF) parents can fill out & give to vaccine providers for them to sign so they can assume responsibility if you or your child gets sick from the vaccine.

It’s very important to include this notice of liability letter to take with you if you’re having you or your child vaccinated. Fill out your information in the letter and then REQUIRE the vaccine provider to sign it before you or your child is vaccinated. This document will ensure their liability and responsibility for any and all injuries or illnesses that may occur as a result of the toxic vaccine ingredients (see Vaccine Ingredients List on Previous Post). Hold your legal, medical, and educational professionals accountable; respectfully require them to take responsibility for their actions. Is this not what we teach our children?

Click here for a Liability Letter (PDF) parents can fill out & give to vaccine providers for them to sign so they can assume responsibility if your child gets sick from the vaccine.

Below is the letter in full:

“- AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY – – NOTICES AND CONDITIONAL ACCEPTANCE –

Herein the terms “administration” and “administrators” refers to all parties providing and/or “mandating” vaccine services and products including vaccine manufacturers, Distributors, Hospitals, Clinics, Physicians, Nurses, Government Agents and Agencies, Healthcare Providers and all other parties bringing vaccines to application or to market in any way.

This is agreement between the parties identified herein who on one hand, will receive vaccinations or be affected by the consequences of vaccination including the vaccinated party/s their guardians, representatives and all persons of common interests and, on the other hand, the administrators and providers of the vaccine/s in all the various capacities. Those parties are identified herein as:

Individual intended for Vaccination:____________________________________ Circle one: Adult Minor

Parents’ or Guardian’s Names and/or Head of Household: ____________________________________ Children’s names (all family members):____________________________________ __________________________________________________________________________________ Address:____________________________________ Phone:____________________________________

Other contacts if available:____________________________________

and Vaccine Administrators (below)

Authorized Officer of Vaccine Manufacturer, Name:____________________________________ Title:____________________________________ Address:____________________________________ Phone:____________________________________

Driver’s license number:____________________________________
Alternate contacts and identification:____________________________________

Authorized Officer of the Organization Administering Vaccinations, Name: ____________________________________

Page 1 of 8

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
Title:____________________________________ Address:____________________________________ Phone:____________________________________
Driver’s license number:____________________________________
Alternate contacts and identification:____________________________________Authorized and Accountable Officer of any “mandating” government agency, Name: ____________________________________ Title:____________________________________ Address:____________________________________ Phone:____________________________________Driver’s license number:____________________________________
Alternate contacts and identification:____________________________________

Individual Administering the Vaccination to the Vaccine Recipients (Nurse, Healthcare Provider or Other, Name:____________________________________ Title:____________________________________ Address:____________________________________ Phone:____________________________________

Driver’s license number:____________________________________
Alternate contacts and identification:____________________________________
I hereby agree to and with the following stipulations, terms, declarations and positions:

1. I am aware and understand that vaccines are not a perfect or fully proven method of disease control.

Page 2 of 8

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
2. I am aware and understand that vaccines are not 100% effective.
  1. I am aware that vaccines have not been tested enough to show that they are 100% safe and effective.
  2. I am aware and understand that vaccines can cause death or injury and disease which seriously and negatively affects the lives of vaccinated individuals, their families and their communities.
  3. I am aware and understand that vaccines, when causing disease and injury, can cause major costs to individuals, families and communities, which costs are solely the responsibility and liability of the causing agents which are the administrators and providers of a harming or ineffective vaccine.
  4. I am aware and understand that vaccines cause risk which is the sole responsibility of the administrators and providers of the vaccine.
  5. I am aware and understand that no one may be forced, coerced or compelled to accept medical treatment or foreign substances inserted into their bodies without full voluntary consent under full disclosure and that administering a treatment, harmful or otherwise, without consent of all affected parties is unlawful and unethical.
  6. I am aware and understand that vaccinations do, on occasion, cause harm, injury and disease including the disease they are intended to prevent.
  7. I am aware and understand that there are particular dangers and hazards of combining more than one vaccination in one or sequential administrations and some of those hazards and dangers are not well understood and have not been fully researched, tested or proven safe or effective.
  8. I understand that individuals have different physiologies and that a vaccination which may be harmless to one individual may be quite harmful to another individual.
  9. I am aware and understand that, prior to administration of any vaccination, administrators of vaccinations must and shall disclose to all interested parties all known and presumed risks, hazards, harm and failures of vaccinations and all contents of the proposed vaccination/s including all trace chemicals, adjuvants and components whether or not administrators consider those elements to be of consequence so that the recipients of vaccinations can make fully informed decisions with regard to accepting vaccination.
  10. I am aware and understand that administration of vaccinations without full disclosure and full voluntary consent of all interested parties and imposing risk and hazard in that way represents criminal violation, malpractice and major liability of the administrators of the vaccination to the vaccinated party/s should any negative consequences arise.
  11. I am aware and understand that any person who attempts to enforce a “mandate” in forcing or coercing vaccination or any other medical treatment upon any unwilling or uninformed party,Page 3 of 8
AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
whether or not that “mandate” is provided in law, codes or regulations, is personally fully liable for any and all harm, loss, damage, negative consequences of the vaccination upon the vaccinated party and all other interested parties. That liability extends to all administrators of that “mandate”, all legislators who were involved in the creation of that “mandate” and all companies and individuals who promoted that “mandate” through lobbying or other political action and all parties who participate in the enforcement of the “mandate”.

  1. I understand that, as an administrator or provider of any “mandated” vaccination I am assuming all liability, obligation and responsibility for any and all negative and/or unintended consequences of the administration of the vaccine and that I must “make whole” the recipients of the vaccine, their guardians, families and community for any and all financial and personal harm, damage and losses caused by the vaccine and any and all harm which may be reasonably attributed to the vaccine. I understand that this is necessary because laws to not adequately protect vaccine recipients and, in fact, put the public at risk of uninsured harm from vaccines.
  2. I am aware and understand that I must disclose all risks of vaccination prior to administration of the vaccine and, because vaccinations do pose risks, I must allow the recipients, guardians and families to refuse the vaccination at their sole discretion, and that disclosure of hazards and risks does not absolve me from any responsibility, liability or accountability for negative consequences of the vaccinations I administer.
  3. If a person suffers any disease or injury at any time after vaccination and not before vaccination and that disease or injury cannot be affirmatively attributed to any particular cause other than the vaccination, then I agree that it is reasonable to presume that the injury or disease was or may have been caused by the vaccination and I will so presume and accept that theory in the absence of compelling evidence to the contrary.
  4. If the vaccine recipients, guardians, family members and interested parties of the vaccinated party should, after the vaccination, submit claims for harm, loss, damages, injuries or disease which they reasonably suspect to be caused fully or partially by the vaccination, then the claims must and shall be paid and delivered by the administrators of the vaccination (above) to the claimant/s without challenge within 30 days from submission of each claim and any challenge to the claim/s must be made through formal written process and/or legal action. Requests for recovery of claims paid must be supported by fact, evidence, law and moral cause. Refusal or obstruction of service of claim shall not reduce obligations and shall be cause for escalated claim.
  5. I am aware and understand that all administrators of vaccinations are responsible for any emotional distress caused by their vaccinations and are liable for compensation for such emotional distress to the victim/s.
  6. Administrators of vaccinations hereby agree that they will allow and facilitate recording, videotaping, documentation and investigation of all services and processes they administer to the vaccine recipient and that administrators of vaccinations will not refuse or obstruct that information gathering for such reasons as “privacy” or “security”.Page 4 of 8
AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
  1. I am aware and understand that any failure or refusal to sign this agreement causes suspicion of intention to do harm to the vaccinated party and others and to avoid responsibility for potential harm that may be caused by vaccination, and I am aware and understand that failure or refusal of signature of this agreement by any administrator of vaccines is cause for rightful refusal of vaccination by the intended vaccination recipient with law, code, regulations, contracts and “mandates” notwithstanding.
  2. Any threat of consequence for refusal of vaccination/s, such as removal from school, quarantine, “child endangerment” etc. is coercion, is offensive, inappropriate, unlawful and violates parental rights. There is no law and can be no valid law which would rightfully grant authority over any individual to determine medical treatment for any other party who is in possession of their faculties. Refusal of vaccination does not in any way imply poor judgment, diminished capacities or social irresponsibility.
  3. I am / am not (circle one) claiming that I personally have the right and authority to force medical treatment and vaccinations upon the party (above) whom I intend for vaccination without his/her consent. If I claim that authority, then I will provide all legal and official reference which bestows that authority upon me specifically against the intended recipient of the vaccination, as authorized and consented by that recipient. I understand that I must provide evidence of authority to the satisfaction of all interested parties before the person intended for vaccination may be vaccinated because the interested parties presume that no such authority exists nor can exist, and, in many cases, the harm caused by vaccinations cannot be reversed.
  4. I understand and agree that the person intended for vaccination is not responsible to gather signatures on this form. The parties intending to vaccinate must acquire and share this form, sign it and deliver it in multiple copies to any party intended for vaccination upon request. At such time as the duly signed forms are delivered to the person intended for vaccination, those agreement forms will be signed by the person intended for vaccination or by his/her guardian and one copy will be returned to each administrator of the vaccination/s. If one of the requested administrators above fails to sign and return the form, all agreements are void and vaccination is rightfully refused.
  5. 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 any vaccine administrators listed above, 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 and liabilities arise from non-consensual vaccination whether or not the vaccination causes physical injury or disease.

Page 5 of 8

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
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.

NOTICE: A separate agreement must be signed for each individual intended to be vaccinated. SIGNATURES OF THE AGREEING PARTIES
Individual intended to be Vaccinated:____________________________________
Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Parents’ or Guardian’s Names and/or Head of Household (if different from above): ____________________________________
Print name:____________________________________ Date:____________________________________

Authorized Officer of Vaccine Manufacturer:

____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Page 6 of 8

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
Authorized Officer of the Organization (clinic, hospital or office) Administering Vaccinations: ____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Individual Administering the Vaccination to the Vaccine Recipients (Nurse, Healthcare Provider or

Other), Name:____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Authorized and Accountable Officer of any “mandating” government agency or program:

____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Authorized Officer responsible for distributing the Vaccination to healthcare facilities and providers:

Page 7 of 8

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES
Name:____________________________________ Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________ Date:____________________________________

Page 8 of 8
AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY and NOTICES”

Urgent: We Need People to Deliver These Papers to All Private Schools Especially Amish & Mennonite Ones!

Updated! – Letter of Liability Below for Vaccine Providers

Click to view this story on our podcast here on YouTube page don’t forget to subscribe and click that little bell to get our latest updates.

https://youtu.be/DZ2wZoTWtYI

We have the solution for the vaccine nightmare, at least for private schools: simply change your status to a homeschool co-op. Each parent can mail a very brief letter of intent to homeschool, a separate letter should be sent for each child. Keep the original for your records and mail a copy to the superintendent of the school district in your area. Because the Amish and Mennonites do not have the Internet or social media, we are making a particular effort to deliver copies of these papers to them personally. Please help all private schools preserve their way of life by transitioning into a homeschool co-op.

Click here to download the letter of intent (PDF) to homeschool.

Click here to download the flyer (PDF) that goes along with the letter.

NEW! – Click here for a Liability Letter (PDF) parents can fill out & give to vaccine providers for them to sign so they can assume responsibility if your child gets sick from the vaccine.

Click here to download the list of vaccine ingredients (PDF).

Remember to include all these documents in your package for the potential homeschooler. Thank you very much for helping us get these papers to as many parents as possible!

cropped-courtroomwatchlogo2Here’s the full text of the letter to homeschool, which you can print out by clicking on the PDF link above:

To:                                                                                                              Date:

Address:

From:

Address:

Notice of Intent to Homeschool

Greetings, this letter is notice that I, ___________________, intend to

homeschool my child, ____________________, for the upcoming/current school year

20_____-20_____, His/her grade will be _____;

Sincerely,

____________________________

 

cropped-courtroomwatchlogo2Here’s the full text of the vaccine info flyer, which you can print out by clicking the PDF link above:

Protect your children!

Change your private school to a ‘homeschool co-op’

Throughout New York state, county and state employees of the ‘health department’ are trespassing upon Amish and Mennonite private property attempting to force parents to submit their children to the needle, or else watch their private schools be forcibly shut down. Vaccines are NOT safe, and even if someone thinks they are, forcing them on others is NOT appropriate. It must be noted that the U.S. Court of Claims has awarded over 4.2 billion dollars to people injured by vaccines. This certainly indicates vaccines are NOT safe. It is dishonest for department employees to refuse to provide a full vaccine ingredients list, which identifies hundreds of harmful chemicals and pathogens present in vaccines. It is dishonest for the county and state employees to refuse to disclose that their pensions are heavily invested in the pharmaceutical corporations that make the vaccines they are pushing. It is also dishonest for county and state employees to refuse to inform you of the solution: simply start a homeschool co-op. As a private school the state demands forced vaccinations, with homeschooling they cannot. The letter provided here can be used, just write your name, address, child’s name and grade, and the year. Mail or hand deliver a letter to the superintendent of your local school district for each child you have. Protect your children! Start your homeschool co-op! For questions or comments call Eric at 585-730-9220. Learn more at courtroomwatch.com.

cropped-courtroomwatchlogo2Here’s the full text of the liability letter, which you can print out by clicking the PDF link above: 

AGREEMENT BETWEEN VACCINE PROVIDERS AND VACCINATED PARTY
NOTICES AND CONDITIONAL ACCEPTANCE

Herein the terms “administration” and “administrators” refers to all parties providing and/or “mandating” vaccine services and products including vaccine manufacturers, Distributors, Hospitals, Clinics, Physicians, Nurses, Government Agents and Agencies, Healthcare Providers and all other parties bringing vaccines to application or to market in any way.

This is agreement between the parties identified herein who on one hand, will receive vaccinations or be affected by the consequences of vaccination including the vaccinated party/s their guardians, representatives and all persons of common interests and, on the other hand, the administrators and providers of the vaccine/s in all the various capacities. Those parties are identified herein as:

Individual intended for Vaccination:____________________________________
Circle one: Adult Minor

Parents’ or Guardian’s Names and/or Head of Household: ____________________________________

Children’s names (all family members):____________________________________

__________________________________________________________________________________

Address:____________________________________

Phone:____________________________________

Other contacts if available:____________________________________

and Vaccine Administrators (below)

Authorized Officer of Vaccine Manufacturer, Name:____________________________________

Title:____________________________________
Address:____________________________________
Phone:____________________________________

Driver’s license number:____________________________________

Alternate contacts and identification:____________________________________

Authorized Officer of the Organization Administering Vaccinations, Name:

____________________________________

Title:____________________________________

Address:____________________________________
Phone:____________________________________

Driver’s license number:____________________________________

Alternate contacts and identification:____________________________________

Authorized and Accountable Officer of any “mandating” government agency, Name:

____________________________________

Title:____________________________________
Address:____________________________________

Phone:____________________________________

Driver’s license number:____________________________________

Alternate contacts and identification:____________________________________

Individual Administering the Vaccination to the Vaccine Recipients (Nurse, Healthcare Provider or

Other, Name:____________________________________

Title:____________________________________

Address:____________________________________
Phone:____________________________________

Driver’s license number:____________________________________

Alternate contacts and identification:____________________________________

I hereby agree to and with the following stipulations, terms, declarations and positions:

  1. I am aware and understand that vaccines are not a perfect or fully proven method of disease control.
  2. I am aware and understand that vaccines are not 100% effective.
  3. I am aware that vaccines have not been tested enough to show that they are 100% safe and effective.
  4. I am aware and understand that vaccines can cause death or injury and disease which seriously and negatively affects the lives of vaccinated individuals, their families and their communities.
  5. I am aware and understand that vaccines, when causing disease and injury, can cause major costs to individuals, families and communities, which costs are solely the responsibility and liability of the causing agents which are the administrators and providers of a harming or ineffective vaccine.
  6. I am aware and understand that vaccines cause risk which is the sole responsibility of the administrators and providers of the vaccine.
  7. I am aware and understand that no one may be forced, coerced or compelled to accept medical treatment or foreign substances inserted into their bodies without full voluntary consent under full disclosure and that administering a treatment, harmful or otherwise, without consent of all affected parties is unlawful and unethical.
  8. I am aware and understand that vaccinations do, on occasion, cause harm, injury and disease including the disease they are intended to prevent.
  9. I am aware and understand that there are particular dangers and hazards of combining more than one vaccination in one or sequential administrations and some of those hazards and dangers are not well understood and have not been fully researched, tested or proven safe or effective.
  10. I understand that individuals have different physiologies and that a vaccination which may be harmless to one individual may be quite harmful to another individual.
  11. I am aware and understand that, prior to administration of any vaccination, administrators of vaccinations must and shall disclose to all interested parties all known and presumed risks, hazards, harm and failures of vaccinations and all contents of the proposed vaccination/s including all trace chemicals, adjuvants and components whether or not administrators consider those elements to be of consequence so that the recipients of vaccinations can make fully informed decisions with regard to accepting vaccination.
  12. I am aware and understand that administration of vaccinations without full disclosure and full voluntary consent of all interested parties and imposing risk and hazard in that way represents criminal violation, malpractice and major liability of the administrators of the vaccination to the vaccinated party/s should any negative consequences arise.
  13. I am aware and understand that any person who attempts to enforce a “mandate” in forcing or coercing vaccination or any other medical treatment upon any unwilling or uninformed party, whether or not that “mandate” is provided in law, codes or regulations, is personally fully liable for any and all harm, loss, damage, negative consequences of the vaccination upon the vaccinated party and all other interested parties. That liability extends to all administrators of that “mandate”, all legislators who were involved in the creation of that “mandate” and all companies and individuals who promoted that “mandate” through lobbying or other political action and all parties who participate in the enforcement of the “mandate”.
  14. I understand that, as an administrator or provider of any “mandated” vaccination I am assuming all liability, obligation and responsibility for any and all negative and/or unintended consequences of the administration of the vaccine and that I must “make whole” the recipients of the vaccine, their guardians, families and community for any and all financial and personal harm, damage and losses caused by the vaccine and any and all harm which may be reasonably attributed to the vaccine. I understand that this is necessary because laws to not adequately protect vaccine recipients and, in fact, put the public at risk of uninsured harm from vaccines.
  15. I am aware and understand that I must disclose all risks of vaccination prior to administration of the vaccine and, because vaccinations do pose risks, I must allow the recipients, guardians and families to refuse the vaccination at their sole discretion, and that disclosure of hazards and risks does not absolve me from any responsibility, liability or accountability for negative consequences of the vaccinations I administer.
  16. If a person suffers any disease or injury at any time after vaccination and not before vaccination and that disease or injury cannot be affirmatively attributed to any particular cause other than the vaccination, then I agree that it is reasonable to presume that the injury or disease was or may have been caused by the vaccination and I will so presume and accept that theory in the absence of compelling evidence to the contrary.
  17. If the vaccine recipients, guardians, family members and interested parties of the vaccinated party should, after the vaccination, submit claims for harm, loss, damages, injuries or disease which they reasonably suspect to be caused fully or partially by the vaccination, then the claims must and shall be paid and delivered by the administrators of the vaccination (above) to the claimant/s without challenge within 30 days from submission of each claim and any challenge to the claim/s must be made through formal written process and/or legal action. Requests for recovery of claims paid must be supported by fact, evidence, law and moral cause. Refusal or obstruction of service of claim shall not reduce obligations and shall be cause for escalated claim.
  18. I am aware and understand that all administrators of vaccinations are responsible for any emotional distress caused by their vaccinations and are liable for compensation for such emotional distress to the victim/s.
  19. Administrators of vaccinations hereby agree that they will allow and facilitate recording, videotaping, documentation and investigation of all services and processes they administer to the vaccine recipient and that administrators of vaccinations will not refuse or obstruct that information gathering for such reasons as “privacy” or “security”.
  20. I am aware and understand that any failure or refusal to sign this agreement causes suspicion of intention to do harm to the vaccinated party and others and to avoid responsibility for potential harm that may be caused by vaccination, and I am aware and understand that failure or refusal of signature of this agreement by any administrator of vaccines is cause for rightful refusal of vaccination by the intended vaccination recipient with law, code, regulations, contracts and “mandates” notwithstanding.
  21. Any threat of consequence for refusal of vaccination/s, such as removal from school, quarantine, “child endangerment” etc. is coercion, is offensive, inappropriate, unlawful and violates parental rights. There is no law and can be no valid law which would rightfully grant authority over any individual to determine medical treatment for any other party who is in possession of their faculties. Refusal of vaccination does not in any way imply poor judgment, diminished capacities or social irresponsibility.
  22. I am / am not (circle one) claiming that I personally have the right and authority to force medical treatment and vaccinations upon the party (above) whom I intend for vaccination without his/her consent. If I claim that authority, then I will provide all legal and official reference which bestows that authority upon me specifically against the intended recipient of the vaccination, as authorized and consented by that recipient. I understand that I must provide evidence of authority to the satisfaction of all interested parties before the person intended for vaccination may be vaccinated because the interested parties presume that no such authority exists nor can exist, and, in many cases, the harm caused by vaccinations cannot be reversed.
  23. I understand and agree that the person intended for vaccination is not responsible to gather signatures on this form. The parties intending to vaccinate must acquire and share this form, sign it and deliver it in multiple copies to any party intended for vaccination upon request. At such time as the duly signed forms are delivered to the person intended for vaccination, those agreement forms will be signed by the person intended for vaccination or by his/her guardian and one copy will be returned to each administrator of the vaccination/s. If one of the requested administrators above fails to sign and return the form, all agreements are void and vaccination is rightfully refused.
  24. 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 any vaccine administrators listed above, 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 and liabilities 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.

NOTICE: A separate agreement must be signed for each individual intended to be vaccinated.

SIGNATURES OF THE AGREEING PARTIES

Individual intended to be Vaccinated:____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

Parents’ or Guardian’s Names and/or Head of Household (if different from above):

____________________________________

Print name:____________________________________
Date:____________________________________

Authorized Officer of Vaccine Manufacturer:
____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

Authorized Officer of the Organization (clinic, hospital or office) Administering Vaccinations:
____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

Individual Administering the Vaccination to the Vaccine Recipients (Nurse, Healthcare Provider or

Other), Name:____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

Authorized and Accountable Officer of any “mandating” government agency or program:
____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

Authorized Officer responsible for distributing the Vaccination to healthcare facilities and providers:

Name:____________________________________

Print name:____________________________________

Direct Contact information: _________________________________________________________________________

_________________________________________________________________________________

Date:____________________________________

 

 

 

Shocking List of Vaccine Ingredients – Most of Them Extremely Toxic!

Here is a list of vaccine ingredients. A child or adult receiving the full array of vaccines will have most of these chemicals injected directly into their bloodstream. For more information on the toxicity of each chemical, search for the chemical name along with the words Material Safety Data Sheet (MSDS). Stay tuned for more information regarding these situations of forced vaccinations upon people for simply choosing to exercise their freedom from being forcibly medicated.
Follow up at CourtroomWatch.com throughout the week for more updates and solutions to this problem regarding out-of-control government. Come join the conversation on our Facebook page just click this link here: CourtroomWatchThe following list was obtained from the World Association for Vaccine Education :

#

A

B

C

D

  • Dehydrate sodium hydrogen phosphate
  • Dextran
  • Dextrose
  • Dibutyl phthalate
  • Diethyl phthalate
  • Diethylether
  • Diphtheria CRM197 protein
  • Diphtheria formoltoxoid
  • Diphtheria toxoid
  • Disodium dehydrogenate phosphate
  • Disodium edentate (EDTA)
  • Disodium phosphate dehydrate
  • Dog kidney cells
  • Dulbecco’s Modified Eagle Medium

E

F

  • Fatty-acid ester-based antifoam
  • Ferrum phosphoricum
  • Fetuin
  • Filamentous hemagglutinin (FHA)
  • Formaldehyde
  • Formalin

G

H

I

  • Influenza A virus hemagglutinin
  • Influenza B virus hemagglutinin
  • Influenzae polysaccharides
  • Iron oxide red ci77491
  • Iron oxide yellow ci77492
  • Isotonic phosphate buffered saline
  • Isotonic saline
  • Isotonic sodium chloride solution

K

L

M

N

  • Neisseria meningitides OMPC
  • Neomycin
  • Neomycin sulphate
  • Nicotinamide adenine dinucleotide

O

  • Octoxynol-10
  • Ovalbumin (egg)

P

  • Pertactin
  • Pertussis toxin
  • Pertussis Toxoid
  • Phenol
  • Phospholipids lecithin
  • Pneumococcal Polysaccharide(s)
  • Polyalcohols
  • Polydimethylsiloxane
  • Polyethylene glycol
  • Polygeline
  • Polymyxin B
  • Polyoxidonium
  • Polyribosylribitol phosphate
  • Polysorbate 20
  • Polysorbate 80
  • Potassium chloride
  • Potassium dehydrogenate phosphate
  • Potassium dihydrogen phosphate
  • Potassium diphosphate
  • Potassium glutamate
  • Potassium monophosphate
  • Potassium phosphate
  • Potassium phosphate- monobasic
  • Protein contaminants
  • Protein hydrolysate

R

  • Rabies antigen
  • Rabies: Human Immunoglobulin Antibodies
  • Recombinant HBsAg protein

S

T

  • Tetanus
  • Tetanus formoltoxoid
  • Tetanus protein
  • Tetanus toxin
  • Tetanus toxoid
  • Thimerosal
  • Titanium dioxide
  • Tri(n)butylphosphate
  • Triton N101
  • Triton X-100
  • Trometamol
  • Tryspin

V

  • Vibrio polysaccharide antigen
  • Virus: Coxiella burnetii organisms, killed
  • Virus: Hepatitis A
  • Virus: Hepatitis B
  • Virus: Human papillomavirus (denatured) (HPV)
  • Virus: Inactivated whole avian influenza
  • Virus: Influenza
  • Virus: Influenza virus antigens
  • Virus: Japanese encephalitis (JE)
  • Virus: Measles
  • Virus: Mumps
  • Virus: polio
  • Virus: Rabies
  • Virus: Respiratory Syncitial Virus (RSV)
  • Virus: Rotavirus (live, attenuated)
  • Virus: Rubella
  • Virus: SV40
  • Virus: Vaccinia (smallpox)
  • Virus: Varicella (chickenpox)
  • Virus: Yellow fever

X

  • Xanthan gum

Y

  • Yeast
  • Yeast extract

Photo by Spencer Tulis

Upstate New York Health Department Threatened to Close Amish Private Schools Unless Children are Forcibly Vaccinated

A recent opinion by Monroe County court judge Daniel Doyle agreed with the state legislature’s passing of another tyrannical statute designed to control people’s children and increase its own wealth with large donations from the pharmaceutical corporations that support them. According to sources close to the court proceedings, New York State health departments are now threatening Amish, Mennonites, and many others with state-forced closures of their private schools if they do not allow their children to receive forced vaccinations. These are the types of things going on that the mainstream media and their pharmaceutical corporate advertisers refuse to tell you.

Follow up at CourtroomWatch.com throughout the week for more updates and solutions to this problem regarding out-of-control government. Come join the conversation on our Facebook page just click this link here: CourtroomWatch

Feature photo by Democrat & Chronicle.

Nickerson Prayer Photo Edited by Mainstream Media Manipulators

Here’s a classic example of media manipulation. This magnificent photo was taken of the Nickersons praying near their property, underneath a heavenly light shining through the clouds. In an obvious effort to remove the Biblical implications of this event, the mainstream media manipulators made the following changes:

  • whited out all the clouds;
  • erased the land behind them, giving the impression the family is sitting on the edge of a void;
  • removed the horizon & apparent hills in the distance;
  • blurred out some trees beyond the van;
  • and wiped out the angelic light coming through the clouds.

Editor’s note: We encourage all our activist followers to email this article to the magnificent manipulators at the Clearwater Tribune at cleartrib@cebridge.net.

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Please help the Nickersons by mailing a complaint form, they really work!

The Nickerson family has been evicted from their Idaho home, after paying their mortgage and property taxes on time, and are now camping outside one week before thanksgiving, in the Idaho winter. Their banker, Chase Bank, told the Nickersons: ‘we no longer want to do business with you because you are Christians’. The bank refused to accept any more checks and claimed they were not paid. The supreme witches court of Idaho agreed and refused to hear any evidence from the Nickersons. It should be noted that the Uniform Commercial Code clearly states that if a creditor, like Chase, refuses to accept timely payments, the entire debt is discharged. Unfortunately, our court system has nothing to do with justice.

If you would like to help, please print and fill out the judicial complaint form provided here. It needs to be mailed in (David W . Cantrill, Executive Director, Idaho Judicial Council, P.O. Box 1397, Boise, Idaho 83701) or sent by fax (208-334-2253), NOT email. Some items to include in the complaint:

  1. Judges refused to hear evidence of timely payments by the Nickersons.
  2. Judges denied 90 percent of disclosure evidence that the Nickersons were seeking from Chase Bank.
  3. Judges took an oath to uphold the Constitution, which guarantees due process and private property rights, both of which were denied by the judges, sheriffs and troopers involved in this case.
  4. Each and every agent of the sheriff’s department, state police, and courts clearly took an oath to uphold the Constitution and then blatantly violated it with this, and other decisions. They broke their oath.
  5. The Constitution clearly guarantees due process to the Nickersons, and the courts and police deprived them of that.

Here are the names of the 2 District Court judges:

  • Michael Griffin, Idaho District Court; Orofino, Idaho; Clearwater County;
  • Gregory FitzMaurice, Idaho District Court, Orofino, Idaho; Clearwater County.

Here are the 5 State Supreme Court judges:

  • Joel Horton, Idaho Supreme Court, Boise, Idaho; Ada County;
  • Jim Jones, Idaho Supreme Court; Boise, Idaho; Ada County;
  • Daniel Eismann, Idaho Supreme Court; Boise, Idaho; Ada County;
  • Roger Burdick, Idaho Supreme Court; Boise, Idaho; Ada County;
  • Warren Jones, Idaho Supreme Court; Boise, Idaho; Ada County.

A high-ranking Connecticut judge, who had a propensity for kidnapping children through the court, was denied by the Connecticut legislature and not allowed to continue her next term. Another example is Tania McCash, whose case was dismissed after a barrage of complaints to the California judicial oversight commission. Get involved! Be an important part of these victories! There is no risk and the rewards are enormous. Have courage and help a brave family who are standing for their rights and suffering for their faith. Please activate!

David W. Cantrill, Executive Director, Idaho Judicial Council,  P.O. Box 1397, Boise, Idaho 83701; Phone: (208) 334-5213 Fax: (208) 334-2253

 

Pray for the Nick and Donna Nickerson Family – Idaho Ranch Update November 25, 2019

Dear Friends and Family,

God is good all the time. And you know what? All the time, God is good. We are all together and have not forgotten that no matter what we are going through, God is still on His Throne. This has been somewhat of a rough week, but we are committed to rejoicing and being glad in the Lord always. We believe each day, even this past Tuesday, is a day the Lord has made. For some reason, some very evil men and women have decided we need some extra blessing – Blessed are ye, when men shall revile you, and persecute you, and shall say all manner of evil against you falsely, for my sake. Rejoice and be exceeding glad: for great is your reward in Heaven: for so persecuted they the prophets which were before you. We are all doing well. Our resolve to do the right thing is as strong as ever. We know we are standing on the truth and are trusting the truth will set us and our Idaho Ranch free. Thank you for your outpouring of love, prayers, and support. We are shocked, saddened and angered with the treachery, deception, and maliciousness we have been attacked with this week. From our perch on the hillside above our ranch, we are witnessing and being victimized by a Constitutional crisis in Clearwater County, Idaho. Sadly, it is being led by those who are supposed to protect us and being endorsed and validated by those who should know better. Our statement and details of our story will be released soon.

All truth, facts, and law refute the many lies being told and prevent any of the atrocities we have suffered this past week regarding our Idaho Ranch. Some of you have asked for facts to refute the questions and commentaries being hurled at you. Below are a few statements to clarify the true history of our battle to save the ranch and to correct the false claims being reported by others.

1) We have committed no act or inaction to warrant or justify our property being taken from us. We did not miss eleven payments and the Court did not find that we did. We were on time and current in January 2010 and were maliciously prevented from performance from that time forward. Deficient accounting practices and malicious prevention of performance created any and all false claims of delinquencies or default. To be clear, we made every payment we were allowed to make and expended heroic efforts to FORCE the banks to work with us, take our payments, and allow us to rightfully save our ranch and entire financial portfolio. Though certain situations exist where a homeowner fails to make payments, and their failure to perform may warrant a foreclosure of their property rights, ours did not. This is judicial theft and mortgage terrorism, not a lawful or rightful foreclosure.
2) We are the sole and rightful owners of our Idaho Ranch. We own our Idaho property by Warranty Deed, not a Deed of Trust. We did not agree to nor execute a Deed of Trust against our property in 2002. The Deed of Trust being publicized is definitively fraudulent and was not executed by us. The document presented cannot even be lawfully used on a 50-acre agricultural property in the State of Idaho.

3) PHH was not the purchaser of our property at a foreclosure sale, is not currently the owner of our property, and has never been the lawful owner of our fifty acre ranch. Dispossessing us of our ranch through an ejectment action without fully establishing PHH to be the owner of our property is illegal, unconstitutional, and constitutes judicial tyranny. This is especially true with all the evidence of fraud the court has refused to consider or allow in the record.
4) Ejectment, which is an eviction action used to dispossess a rightful owner of their property, is governed by common law in Idaho. The writ executed on November 12 was signed on September 10, making it over 60 days old.

5) The ejectment action executed on November 12 was filed the end of 2018, not eleven years ago as recently reported. Ejectment efforts began fall 2018. We were informed all ejectment efforts were stopped as of September 2019. It was our understanding on the morning of November 12 that we were rightfully in possession of our ranch and were awaiting justice to be rendered through appeal or by escalation to higher courts. A stay pending appeal was not in place due to the personal assurances of Sheriff Chris Goetz that the possession of our property was not in jeopardy.

6) Forcefully dispossessing our family from our ranch on November 12 was not legally, morally, or ethically justified or warranted. We are the sole and rightful owners of our Idaho property and have committed no action or inaction to breach or violate any alleged agreements. We have not abandoned or vacated our property and have publically and judicially stated our resolution to maintain ownership.
7) Sheriff Chris Goetz, along with local deputies and the Idaho State Police, led an armed raid against our persons and our property on November 12 two weeks before Thanksgiving. The raid was not peaceful and was aggressively conducted against our wishes and without any lawful order. The writ executed required the Sheriff to cause us to remove our personal belongings PRIOR to being authorized to remove them himself. Clearwater County Sheriff Chris Goetz had previously informed us all efforts to remove us from the property had ceased and assured us he would inform us if anything changed. Further, he provided assurances we would have three to four week notice should the banks choose to move forward again. We were not served prior to the November 12 raid.

8) The raid lasted over 15 hours, not just a few hours as reported. Reports it was conducted without violence are comprehensively untrue. Snipers with assault rifles drawn were in position in the early hours of November 12. We were lured to the Sheriff’s office for a 9 a.m. meeting on November 12 in thick fog with assurances nothing was happening. The ranch invasion began upon our departure from the ranch. The raid did not end until between 12:30 and 1 a.m. November 13. The property has been secured with armed guards ever since. We have been told we will be shot if we enter our property. Details of the raid are being documented and will be online soon.

9) No due process or jury trial has occurred in this case. All judgments in PHH’s favor have been awarded by summary judgment. No admissible evidence has ever been provided by PHH Mortgage Services to demonstrate their ownership, any existence of a default caused by us, or any established standing for PHH or any other entity to bring a foreclosure suit against us. The foreclosure sale of our property was executed with an expired writ, referenced a void judgment, violated Idaho code regarding order and conduct of sale, contradicted the subsequent writ and Sheriff’s Deed issued to PHH Mortgage, accepted a grossly inadequate sales price, and other such illegalities. We challenged the authenticity and enforceability of the sale before, during, and after the sale. JPMorgan Chase still claimed to be the owner of the property post judgment, after the alleged foreclosure sale, and after the issuance of the Sheriff’s Deed in PHH’s name. This is a wrongful and fraudulent foreclosure and it has been pursued maliciously without cause, right, or legitimacy.

10) We did not fail to redeem the property. We were denied our one year right to redemption due to illegalities surrounding the foreclosure and resulting Sheriff’s Sale. There were three contradictory claims to ownership in effect during our redemption period by three different mortgage related entities. Any attempt by use to redeem the property would have legitimized their fraudulent and illegal foreclosure proceedings and negated our judicial standing.

11) Reports we were given three opportunities to present evidence and failed to act is irrefutably untrue. Summary judgment was granted to Chase and a partial summary judgment was granted to PHH in 2012 without our knowledge or involvement. Our attorney has formally admitted he lied to us, negligently failed to present evidence provided to him, and concealed the true status of our case from us. We were denied opportunity to amend our complaint or expand the factual record of the case when we assumed responsibility for representation post those underlying foreclosure judgments. The court refused to consider around 400 pages of testimony and evidence that supported our claims and refuted all claims against us. Our rights to conduct discovery were and have been comprehensively and systematically denied. All attempts to enter evidence were blocked or disregarded. No trial or evidentiary hearing was ever held. All requests to provide witness testimony have been denied. We have never stood before a jury of our peers. An appointed, not elected judge, signed the writ for the dispossession of our property. We are victims of systemic corruption, procedural manipulation, mortgage terrorism, police brutality, and judicial tyranny, not ineffective self-representation.

12) All truth, facts, evidence and laws are on our side. We are fighting this battle because it is the right thing to do.

Our story of the horrific events of November 12 and all we have endured since are being documented and will be uploaded soon. There is much to tell of this violent assault on our family, animals, ranch, and even innocent neighbors and friends in the vicinity. Our house and all buildings were forcibly broken into by physical force – kicking, large bolt cutters, axes and clubs – even though a locksmith was onsite. Mud, leaves, and debris was tracked all over a white carpet that a family of 10 had kept meticulously clean. Windows were broken with glass left lying all over the floor and porches to rip the carpet, injure our animals, and mar decking when walked on. Broken canning jars filled with pumpkin for Thanksgiving pies and breads were left on the flooring to stain the tiles, carpets, and spread the orange colors all over the house. The guesthouse hot water heater was drained onto a carpeted wood floor and the carpet was left wet with no fans or other restoration efforts in place or attempted. A female family member was double handcuffed and left to sit in cold rain on a brick retaining wall for an extended period of the time when over 7000 sf of covered roofs were available. Dogs trying to defend their home from men wearing body armor and drawn assault rifles who were screaming and breaking into our buildings were pepper sprayed, beaten, apparently tranquilized or knocked unconscious. Cut fencing was not repaired so the dogs were then left to run loose in the community and place other livestock at risk when the raid was over. We requested our belongings be driven to our neighbors. The Sheriff and onsite SWAT team refused. We requested our food, frozen goods, and other perishable items be allowed to remain at the property until stores opened the next morning and new refrigerators and freezers could be purchased. Our requests were denied and our freezers were emptied into black trash bags and brought to us on the side of the road. Officers with assault rifles drawn watched while we unloaded four large freezers (over 60 cubic feet) from the back of moving trucks onto a gravel pullout. Refrigerated items and some of the pantry items were also brought to the side of the road. We requested toothbrushes, pajamas, our Bibles, a change of clothes, our coats. All were denied. We asked for a one hour cease and desist to be able to request a stay. It was denied. All legal paperwork, notes, and evidence were stolen from the property to prevent us from showing and telling our story to those who might help stop the unwarranted assault. Neighbors were threatened with being shot. For over 15 hours Sheriff Chris Goetz, his team of heavily armed desperados, and their armed accomplices from the Idaho State Police held our family hostage on the side of the road in the rain with temperatures in the 30’s. No food, water, bathrooms, or other humane concerns for our health and safety were offered. We were not allowed to enter our home or retreat from the area. The only relief received was offered by friends and family.

There is much more to share. Our statements are being prepared. Our stand is we have not relinquished possession of our property even though our physical presence has been violently removed and blocked. This was an armed invasion by the police powers of the State of Idaho in a civil matter that was determined without any due process. It was pre-planned and executed with intent to harm, not protect. Two staging areas were set up to execute this raid – one at the Idaho National Guard on Hwy 12 and the other near the Idaho State prison located on the outskirts of Orofino. Deputies had already secured the perimeter of our property when we were informed the raid was commencing. State police flew past us as we returned to our property after finding out we had been double crossed by Sheriff Chris Goetz with the approval of County Prosecutor Clayne Tyler. Prior to us returning to our ranch to witness the stripping of our property rights under a waving American flag, we personally informed the Clearwater County District Court; County Commissioners Mike Ryan, Rick Winkel, and others present and/or listening to their session by phone; Clerk of the Court Carrie Bird; Clearwater Tribune writer Elizabeth Morgan; and other public officials who will be named in our detailed documentary. Armed guards were staged behind us as we passed predisposed checkpoints. Friends in the area travelled toward us to warn us we were being ambushed by officers with guns drawn. The road to our property was blocked with at least six law enforcement vehicles. The property was surrounded by snipers. We did not leave our ranch willingly and we formally claim and preserve all rights to the ownership of our property and intend to maintain full possession of our ranch as the only true and rightful owners.

Unbelievable is the only word we have to describe what has and is happening. The reality is it happened to us, and the undeniable truth is it could happen to you. Pray and share our story.

 

If God be for us, who can be against us? Romans 8:31

The Lord is on my side; I will not fear: what can man do unto me? Psalm 118:6

 

Finally, my brethren, be strong in the Lord and in the power of His might. Put on the whole armor of God, that ye may be able to stand against the wiles of the devil. For we wrestle not against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this world, against spiritual wickedness in high places. Wherefore, take unto you the whole armor of God, that ye may be able to withstand in the evil day, and having done all, to stand. Ephesians 6:10-13

God is still on His Throne, and He is the One who will render the final judgments in this matter. We pray God renders to each man according to his deeds. As we continue the fight, it is in God we trust.

Walking in that peace that passes all understanding,

The Nick and Donna Nickerson Family

Emergency Update in the Anna Taylor case.

The police stayed back after we went off the air, and kidnapped Anna’s child. At least the police were persuaded to leave the child with a family member & not turn the baby over to DCF.
Please escalate your support for Anna Taylor and demand reunification with her child who can legally be held for only 96 hours pursuant to the Connecticut statute. After that, the baby must be returned to Anna. And with enough public support this can happen.
Follow her case at CourtroomWatch.com.
Again, here is the number for the Waterford Police Department to call and require them to return Anna’s child to her:
860-442-9451 Press 7 for the Court Officer, and 8 for the Chief of Police.