Variety
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"My Bike" Program Application


Variety's "My Bike" Program currently provides Rifton adaptive bikes to children with disabilities who meet the following eligibility criteria:

  1. Reside in one of the counties that Variety serves, including: 22 counties in Western Pa. (i.e. Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Centre, Clarion, Crawford, Erie, Fayette, Greene, Huntington, Indiana, Lawrence, Mercer, Somerset, Venango, Warren, Washington, and Westmoreland), 7 counties in Central Pa. (i.e. Cumberland, Dauphin, Juniata, Northumberland, Perry, Snyder, and York), or 10 counties in West Virginia (i.e. Barbour, Doddridge, Harrison, Marion, Marshall, Monongalia, Ohio, Preston, Taylor, and Wetzel).
  2. Have a documented physical, mental, or sensory disability documented by your child's current physical / occupational therapist, or personal care physician.
  3. Be between the ages of 4 through 21.
  4. Submit a completed "My Bike" Application.
  5. Applicant's household income must meet Variety's "My Bike" Program income guidelines. Income verification will be required.
     
    # Household Memebers Household Salary

    2

    $63,720

    3

    $80,360

    4

    $97,000

    5

    $113,640

    6

    $130,280

    7

    $146,920

    8

    $163,560

    *For each additional person, add $16,640.

  6. Submit a letter from your child's current physical / occupational therapist, or personal care physician indicating that an adaptive bicycle would be medically appropriate and therapeutic for the child and that a conventional bike would not be appropriate (see pages 13-14 for additional information on letter). 
  7. The successful trial of a Rifton adaptive bike, in which the child is individually fitted / evaluated on a Rifton adaptive bike, and the bike size, color, and adaptations are decided (this is the final step in the application process once everything else is completed - see page 15 in the application for more details).
  8. Variety requires the applicant and his/her parent or legal guardian to attend a scheduled regional presentation to receive the equipment in order to properly review all safety and equipment specifics before it is taken home.

If you are in one of the 39 counties in PA or WV, please click here to apply.

If you are outside of Variety's 39 county service area then click here.

For Questions or Assistance...

Please give us a call at 724-933-0460.




"I just coldn't believe how quick and easy the process was to get Trinity her bike."
-Kelley, mother of Trinity