"My Bike" Program Application
Variety's "My Bike" Program currently provides Rifton adaptive bikes to children with disabilities who meet the following eligibility criteria:
- Location - Reside in one of the 54 counties that Variety currently serves, including: 42 counties in Pennslyvania ( Adams, Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Elk, Erie, Fayette, Forest, Franklin, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lawrence, McKean, Mercer, Mifflin, Northumberland, Perry, Potter, Somerset, Snyder, Union, Venango, Warren, Washington, Westmoreland, and York), and 12 counties in West Virginia (Barbour, Brooke, Doddridge, Hancock, Harrison, Marion, Marshall, Monongalia, Ohio, Preston, Taylor, and Wetzel).
- Diagnosis - Have a diagnosed physical, mental, and/or sensory disability documented by your child's current physical / occupational therapist, or personal care physician.
- Age - Be 4 through 21 years of age. An application may be submitted up to 60 days prior to a child's 4th birthday.
- Application - Current "My Bike" application completed.
- Income - Applicant's household income must meet Variety's "My Bike" Program income guidelines. Income verification will be required.
# Household Memebers Household Salary
*For each additional person, add $16,720.
- Letter of Medical Justification (LMJ) - Submit an LMJ from your child's current physical / occupational therapist or personal care physician indicating that a Rifton adaptive bicycle would be medically appropriate and therapeutic for the child and that a conventional bike would not be appropriate (see pages 12-13 for additional information on letter).
- Trial - 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 14 in the application for more details).
- Presentation Requirement- 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.
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