Parent Permission Form
Event Timing: April 6, 2024
Event Address: Sharadin Arts Building, Kutztown University, Kutztown, PA 19530
Contact us at (610) 737-8217 or theveeringcane@gmail.com
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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.
The contest will be held April 6, 2024.
CONTEST DESCRIPTION:
1. Cane Quest, a program of Braille Institute, is open to visually impaired students in grades 3-6 who have received 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.
2. A student should be familiar with the skills on the checklist, but does not have to have mastered all of them.
3. 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 ahand 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 ofless 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.
Student's First and Last Name (ex. Jane Smith)

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Address (Unit/Ap. No, Street, City, State, Zip) *
Phone

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Emergency Contact Number/Relationship *
Student's Age *
Student's Current Grade
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Name of School *
Name of District

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Student's TVI or COMS
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