Cane Quest 2023 PNW Volunteer Application

Richland School District Attn: Vision Dept.

Email: Linda.Mcfall@rsd.edu or Amanda.Carpenter@rsd.edu 

Any questions, please call: (509) 967-6384 or (509) 967-6597

**The deadline for registering is September 15th**

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 Pacific Northwest Regional Cane Quest will be held in person on October 6, 2023. 

CEU &/or ACVREP credit hours will be available for all who volunteer and support this event.

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Email *
Volunteer Opportunities

•         General Event Volunteers—who assist with registration, lunch, etc. These can be anyone who feels comfortable around children who are visually impaired—a parent, a general education teacher, an agency administrator, etc.

•         O&M Specialists—who are stationed along the route to score each student skill          .        

•         TVIs, grad students or other VI professionals — who Shadow students as they walk the Cane Quest route.

First and last name *
Address (Street, City, State, ZIP) *
Phone number (primary) *
Phone number (secondary)
May we contact you by email? *
Emergency contact name *
Emergency contact relationship *
Emergency contact phone number *
Your T-shirt size (adult sizing) *
Employment (most recent) *
Position *
Duties (short explanation) *
Languages (note whether fluent or conversational) *
Certifications
Signature (Type your full name, this will act as your signature) *
PHOTOGRAPH, EDITORIAL AND RECORDING RELEASE
I hereby authorize Richland School District (“RSD”) and Braille Institute of America, Inc. (“BIA”) to photograph, videotape, or otherwise record by visual, audio, electronic or manual means, the visual likeness and/or voice or other sounds created by the above named individual (collectively “Reproductions”). RSD and BIA may use or permit to be used the Reproductions in any CD, DVD, exhibition, display, publication, solicitation or promotional or educational material or on any website including without limitation RSD and BIA’s website, Facebook, or YouTube without compensation to the contestant, the contestant’s heirs, successors or assigns.
Photograph, Editorial and Recording Release signature (Type your full name, this will act as your signature) *
A copy of your responses will be emailed to the address you provided.
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