I/We agree that this/these action plan(s) are still current for my student without any changes in medication(s) or treatment plan and authorize district employees to continue to use this plan for this school year. I understand that if there are any changes that develop, I/We are responsible for informing the school nurse and obtaining a new emergency action plan from my student’s physician. If I/We fail to do so, I/We hereby release the District, its agents and employees from all liability and damages as a result of any injury arising from following the initial plan by school staff regardless of fault or negligence and agree to indemnify and hold harmless the District, its agents and employees therefrom.

Note: Other forms which are required to be completed in addition to this form: