2027 Student Permission Form - Ohio Regional Braille Challenge

Image shows a black background with the words, "A Decade of Dots - Celebrating 10 Years of Braille Excellence" with Clovernook Clovers on each side. Underneath is a green diamond with the words, "Ohio Regional Braille Challenge 2026" in both print and braille.

2027 Ohio Regional Braille Challenge - Student Permission Form

Hosted by: Clovernook Center for the Blind & Visually Impaired

Must be completed by parent/legal guardian (or by student if over 18) and submitted by Friday, January 29, 2027. (Registrations received by December 18, 2026 will be entered into our Early Bird Drawing for some amazing prizes!) If you have questions or need help filling out this form, please contact our Regional Coordinator, Stephanie Jones, by email at sjones@clovernook.org or by phone/text at 901-428-2942. Only registrations submitted with a signed permission form attached will be eligible for Braille Challenge Finals. Once you submit this form you will receive a link to a signature document. Your child's registration is not complete until we have that signed form.

Once a parent (or student over 18) has submitted this form, the student's TVI will receive a request to fill out additional paperwork.

This year we are thrilled to offer the Ohio Regional Braille Challenge in three locations across the state. We hope this will allow your student to participate at the location most convenient for you and your family. PLEASE NOTE that students may ONLY register and/or attend/compete at ONE location.

(If you should need to change your registration for any reason prior to the event, please contact our Regional Coordinator, Stephanie Jones, by email at sjones@clovernook.org or by phone/text at 901-428-2942. *If you reach out regarding a change, please know that the change is not final until you have received a confirmation email with the approved changes.)

Location choices are: (you may only select one option)

Southern Ohio - Wednesday, February 17, 2027 - College Hill Presbyterian Church, 5742 Hamilton Ave, Cincinnati, OH 45224

Central Ohio - Tuesday, February 23, 2027 - Worthington Christian Church, 8145 N. High St, Columbus, OH 43235

Northern Ohio - Friday, February 26, 2027 - Stark County ESC, 6057 Strip Ave NW, North Canton, OH 44720

Select the Ohio Regional Braille Challenge Competition your student will attend:

Student's First and Last Name

First NameLast Name

Student's Preferred Name (if different from legal name above)

Student's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student's Home County

County where student lives at home

Student's School

Student's School County

County where school is located

Student's Grade in School for the 2026-27 School Year

Birthdate

Date

Age

Gender:

Student's Preferred Pronouns

T-Shirt Size:*

*All registered participants will receive a FREE short-sleeved t-shirt and drawstring swag bag with the logo above. If you would like to order additional 2027 Ohio Regional Braille Challenge merch (short- or long-sleeved t-shirts, crewneck sweatshirts, hoodies, drawstring backpacks, or tablet cases) or other Clovernook Spiritwear, please check out our order form at: bit.ly/ClovernookSpiritwear

Please upload a recent headshot/portrait of your child for media purposes. We sometimes like to highlight participants in the media. Follow us on Facebook/Instagram/LinkedIn and you might see your student featured!

Does participating in Braille Challenge motivate your student to practice braille skills?

How long has your student been participating in Braille Challenge?

Number of years as a participant

Student's Hobbies/Interests: (Please tell us about your child's hobbies or interests that they enjoy.)

Student's favorite school subject:

Please give us 3 adjectives that describe your student:

Lunch (pizza or a boxed-type lunch) will be provided for participants. Please let us know below if your student will be eating the lunch provided or will bring their own lunch. (Some light breakfast items will be available during morning registration as well.)

Please share with us if your student has any allergies or other medical concerns we should be aware of during the event (e.g., food allergies or sensitivities, etc.).

Please give us your child's Teacher of Students with Visual Impairment (TVI)'s Full Name (The student's TVI will be asked to fill out additional paperwork to finalize registration.)

First NameLast Name

TVI's Email Address

example@example.com

Parent/Guardian 1 First and Last Name (or student if over 18)

First NameLast Name

Parent/Guardian 1 Email (or student if over 18)

example@example.com

Parent/Guardian 1 Telephone Number (or student if over 18)

Please enter a valid phone number.Format: (000) 000-0000.

Parent/Guardian 2 First and Last Name (optional)

First NameLast Name

Parent/Guardian 2 Email (optional)

example@example.com

Parent/Guardian 2 Telephone Number (optional)

Please enter a valid phone number.Format: (000) 000-0000.

Household Income (Optional - From Braille Institute: This information helps us better serve our community and reach more students. Aggregate data may be shared with potential sponsors to support program costs. Your responses are confidential and will not affect your child’s participation.)

Who will be attending the event with your student? Please list all persons attending with/on behalf of the student for headcount purposes. Please note that we cannot accommodate siblings who are not registered for the Braille Challenge. All programming is for participants and accompanying adults (parents/guardians and education professionals) only.

Is the adult(s) attending with the student a:

Assistive Technology Description: Please answer the below questions to the best of your ability. We use this information to track what devices Braille Challenge participants are using.

Have you ever used a refreshable braille display?

Do you have regular access to a refreshable braille display or braille notetaker?

If yes, what is the name of the device you use

Have you paired a refreshable braille display or notetaker to an iPad, iPhone, or Android device?

From Braille Institute: Finals Eligibility

Braille Institute takes pride in all students who compete during Braille Challenge at their regional event and we celebrate all of them individually. Every student who competes should be proud of what they've accomplished, therefore, we encourage students to give each contest their best effort.

The invitation to Braille Challenge Finals is open to 50 students. Each category is comprised of 10 students who have scored the highest based on scores from regionals across the world.

Eligibility criteria for Finals:

Testing at their grade and age level
- Note: Apprentice are eligible only if testing in contracted braille.
Participating at the preliminary round

How does Braille Institute calculate the top ten students’ scores?

After all Regional events have wrapped, we pool together students’ scores from all regionals. Finalists are determined by comparing ratio scores. A raw score is the number of points a student earns on a contest, while a ratio score adjusts that score based on the performance of students in the applicable comparison group. This method allows participants across different regionals to be compared more fairly.

For more than a century, Braille Institute has empowered children and adults at every stage of vision loss through free programs and services. Our programs reach individuals and families across the country and around the world, with new virtual opportunities continually expanding our reach. We encourage you to visit www.brailleinstitute.org/find-services/youth/ to explore our virtual services.