<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.06.05.06" title_num="10" subtitle_num="06" chapter_num="05" heading="Waiver Form.">
  <paragraph num="A.">
    <text>A waiver form for an individual 18 years old or older shall:</text>
    <paragraph num="(1)">
      <text>State that the individual:</text>
      <paragraph num="(a)">
        <text>Is 18 years old or older;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has received and reviewed the information provided by the institution of higher education on the risk of meningococcal disease and the availability and effectiveness of meningococcal vaccine; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Chooses to waive the receipt of meningococcal vaccine; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide spaces for the:</text>
      <paragraph num="(a)">
        <text>Printed name of the individual;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Signature of the individual; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Date.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A waiver form for an individual younger than 18 years old shall:</text>
    <paragraph num="(1)">
      <text>State that:</text>
      <paragraph num="(a)">
        <text>The individual is younger than 18 years old;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The parent or guardian of the individual has received and reviewed the information provided by the institution of higher education on the risk of meningococcal disease and the availability and effectiveness of meningococcal vaccine; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The parent or guardian of the individual chooses to waive the receipt of meningococcal vaccine for the individual; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide spaces for the:</text>
      <paragraph num="(a)">
        <text>Printed name of the individual;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Printed name of the parent or guardian;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Signature of the parent or guardian; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Date.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>