It is the position of the National Association of School Nurses (NASN) that all students, including those with disabilities or special healthcare needs, must have equal opportunity to safely take part in school-sponsored before, after, and extended school year programs and activities, also known as Out of School Time (OST). The registered professional school nurse (hereinafter referred to as school nurse) has the knowledge, skills, and expertise required for assessing, planning, coordinating, implementing, and evaluating student healthcare needs so that all students may fully participate in OST programming and activities. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in January 2014 and revised in June 2018.]