In today's world, students are busy! Education no longer takes place in a single classroom. Schools take field trips to historic sites, museums and nature centers. Class groups attend plays, concerts, and sports competitions off school grounds. Some school groups take overnight trips and week-long camping trips. Many students take part in band, choir, student council, sports and drama activities that meet before or after the regular school day. In addition, school days are longer than ever. Students may also be involved in before and after care programs or tutoring programs at school.

This page is designed to help parents and guardians make sure that students with diabetes have a chance to fully and safely participate in all school activities—including field trips and extracurricular activities. It also explains what students' legal rights are.

My child wants to take part in class field trips and extracurricular activities. How can I prepare?

Class trips usually require students to travel off of school grounds. Many student activities—including sports—take place outside of regular school hours. With careful planning, creative thinking and a few small adjustments, students with diabetes can be fully included in all school events and activities. The following steps may help:

• Send supplies: Some students may store supplies at school, or keep them inside the nurse's office during the school day. But students need access to diabetes care equipment at all times. Students should be allowed to carry or store their supplies in a safe, but easy-to-access place during field trips and extracurricular activities.
• Request staff training: Many students need assistance with diabetes care tasks. For example, some students may need help testing their blood glucose or administering insulin. They also need somebody trained in emergency glucagon administration onsite at all times. Work with school officials to be certain that there is a trained staff member, chaperone or coach available to help students with diabetes care during all field trips and extracurricular activities.
• Adjust schedules: Field trips and extracurricular activities can mean a change in schedule or a change in activity level for students. For example, on a class trip, lunch might be scheduled at a different time than it usually is during the school day. A student might also use more energy while on a camping trip than while sitting at a desk. These changes can affect when insulin should be given and how much should be given. Make sure you plan ahead! Talk with your child's doctor or health care provider about any adjustments that are needed to his or her diabetes care during field trips or extracurricular activities.
• Ask about essential issues: Students with diabetes need regular access to food, water and the restroom. Before any class trip or activity, remind the teacher or event organizer that your child will need snacks and a water bottle, and should know where the closest bathroom is at all times.

Are there laws that protect my child during field trips and extracurricular activities?

Yes. There are two federal laws that protect students with disabilities—including diabetes—from discrimination. These two laws help make sure that students with diabetes get the care they need, receive fair treatment and are given the chance to take part in field trips and extracurricular activities. State laws may provide additional protections.

Section 504 of the Rehabilitation Act of 1973, often known as "Section 504," prohibits programs that get federal funding from treating children with disabilities—like diabetes—unfairly. It gives students with disabilities the right to the care they need to be safe and fully participate in all school activities—including field trips and extracurricular activities. Under Section 504, diabetes is a disability so every child with diabetes is protected against unfair treatment.

A disability under Section 504 is a "physical or mental impairment that substantially limits one or more major life activities." Individuals with diabetes are considered to have a Section 504 disability because their endocrine system, a major life activity that helps regulate bodily functions, is substantially limited. This is another way of saying your child's endocrine system does not work correctly because it does not produce and/or use insulin properly. Your child does not need to be having academic difficulty in order to be protected under Section 504. Religious schools that receive federal funding must comply with Section 504.

The Americans with Disabilities Act (ADA) prohibits most schools from discriminating against children with diabetes. However, religious schools aren't included under this law. Otherwise, the covered disabilities are usually the same and the protections for children are similar as for Section 504.

Can my child be left behind from a field trip because he or she has diabetes?

No. Section 504 applies to all school activities. This includes class trips, field trips, sports, drama, band, student council, school dances, after-school programs, field days, recreational events and school carnivals. The law protects children from unfair treatment in all activities and makes sure that students with disabilities—including diabetes—have the opportunity to take part in them.

Can the school make me attend field trips in order for my child to attend?

No. If the school is inviting parents to chaperone a field trip, it is welcome to invite you as well. If you would like to chaperone your child's field trip and take part in the fun, then you are certainly allowed to do that. However, the school cannot require you to come in order for your child to participate. It is the school's responsibility to provide your child with appropriate care on a field trip just like it is the school's responsibility to provide your child with care during the school day. The school cannot exclude your child from a field trip because you are unable to attend.

Is my child permitted to attend overnight or week-long class trips?

Yes. Class trips are covered by Section 504, even if they require an overnight stay. It is the school's responsibility to make sure your child has access to the care he or she needs on these trips. You cannot be required to attend.

Can the school prohibit my child from participating in sports because he or she has diabetes?

No. Section 504 applies to interscholastic and intramural athletics. The school cannot exclude your child because he or she has diabetes. People with diabetes play virtually all sports at all levels, from Little League to the Major Leagues, from junior varsity to Olympic swimming.

If a position on a team requires competitive skills, your child should be given a fair chance to try out. The school does not have to lower the standards for try-outs, but it should give reasonable accommodations. This might include, for example, time to administer insulin, check blood glucose, eat or take glucose tabs. Every child with diabetes is different, and so are the kinds of accommodations they might need.

Is the school required to provide my child with care at sports, drama, art, music or other activities that take place before or after school?

Yes. It is the school's responsibility to provide your child with care during extracurricular activities. This includes, for example, assistance with insulin administration and blood glucose checks if your child needs help with those activities. It means that students should have access to their diabetes care supplies and permission to check blood glucose, eat, drink water and use the restroom whenever necessary. It means that someone trained in emergency glucagon should be available during before school and after school activities if your child is participating in that activity.

Can my child attend the school after-care program?

Yes. If the after-care program is run by the school, then the after-care program is covered by Section 504. Children must be allowed to participate in the program and the school is required to provide children with necessary care.

If the after-school program is run by an outside agency—like the YMCA—but takes place on school grounds, the school must make sure that children with diabetes are treated fairly. This is because Section 504 does not allow schools to provide "significant assistance" to programs that discriminate against children with disabilities. The outside agency running the program is itself covered by Section 504 if it receives federal funding. It is also independently covered by the Americans with Disabilities Act, another law that protects students with diabetes from unfair treatment (unless it is a religious agency).

Should I write field trip and extracurricular accommodations into my child's 504 plan?

Yes. Including extracurricular activities and field trips in a 504 plan helps establish what types of assistance and accommodations a student will need during these activities. It allows parents or guardians, students and the school to discuss the issues and have a clear plan of how to approach these activities.

Is there any other guidance on this issue?

Yes. The Department of Education's Office for Civil Rights' Dear Colleague Letter: Students with Disabilities in Extracurricular Athletics (PDF) provides more information about the rights of children with disabilities in extracurricular activities. Example #4 on pages 10 and 11 involves a child with diabetes. In this hypothetical, the child receives diabetes care during the school day, but he initially is refused this care for a gymnastics club he wants to participate in. The Office of Civil Rights (OCR) states: "In this example, OCR would find that the school district must provide glucose testing and insulin administration for this student during the gymnastics club in order to comply with its Section 504 obligations."