Apply for Your Bike
Variety’s “My Bike” Program currently provides Rifton adaptive bikes to children with disabilities who meet the following eligibility criteria:
Reside in one of the 54 counties that Variety currently serves, including: 42 counties in Pennsylvania (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).
Have a diagnosed physical, mental, and/or sensory disability documented by your child’s current licensed Physical / Occupational Therapist, or Personal Care Physician.
Be 4 through 21 years of age. An application may be submitted up to 60 days prior to a child’s 4th birthday.
Complete all applicable sections of the Program Application.
Applicant’s household income must meet the income guidelines for Variety’s programs (see pages 6-7 in the application for more details). Income verification will be required.
|# Household Members||Household Salary|
*For each additional person, add $21,600.
Letter of Medical Justification (LMJ)
Submit an LMJ from your child’s current licensed 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 page 10 in the application for more details).
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).
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 homeProgram Application Program Handout “My Bike” Order Form