Scouts Contest Application
Event Timing: April 6th, 2024
Event Address: The Sharadin Arts Building,  Kutztown University, Kutztown, PA 19530
Contact us at (610) 737-8217 or theveeringcane@gmail.com
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Email *
THIS FORM IS TO BE FILLED OUT ONLY BY A CHILD'S CERTIFIED O&M SPECIALIST. CEU credits will be available for all O&Ms who volunteer and support this event.
Cane Quest seeks to motivate blind and visually impaired youth to practice proper safe travel techniques and overall orientation and mobility skills. It’s designed to promote a student’s confidence in any surrounding and build true mobility independence. This form must be completed by an Orientation & Mobility Specialist to validate the student’s skill level and visual acuity. A separate form must also be signed by a parent or legal guardian for a student to participate.
CONTEST DESCRIPTION:
1. Cane Quest is a program developed by Braille Institute and open to visually impaired students in grades 3-6 who have received appropriate instruction in the use of the white cane, and who are both cognitively and physically able to walk independently for an hour at a time. A student should be familiar with the skills on the checklist, but does not have to have mastered all of them.
2. A student’s visual acuity must fall within the B1 through B3 classification range as defined by the United States Association of Blind Athletes.
• Class B1 - No light perception in either eye up to light perception, but inability to recognize the shape of a hand at any distance or in any direction.
• Class B2 - From ability to recognize the shape of a hand up to visual acuity of 20/600 and/or a visual field of less than 5 degrees in the best eye with the best practical eye correction.
• Class B3: From visual acuity above 20/600 and up to visual acuity of 20/200 and/or a visual field of less than 20 degrees and more than 5 degrees in the best eye with the best practical eye correction.
3. Students must use a white cane for this contest, and must wear closed-toe shoes.
4. Students will complete the route or checklist in partnership with a parent or other sighted volunteer, who will be under blindfold for sections of the route.
5. All participants will be monitored at all times throughout the program.
Contestant's Name
 *
O&M Specialist First and Last Name *
Specialist's Address (Street/City/State/ZIP)
Specialist's Phone *
Specialist's E-mail *
Name of School or Educational Institution/District *
Student's Age *
Student's Grade *
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