Order | Adaptive Bike Chairs

ORDER FORM

As each bike chair attachment is made-to-order, we will need you to please fill out the below information. Once we've confirmed that we have all we need, we will send you an invoice for payment. Your order will not be placed in the production queue until payment has been received.

Address (Please do not leave off your City, State, and Zipcode)

Harness - Please select your choice of seatbelt or harness.

First / Last Name

Phone

Shipping - Please select your choice of shipping or pickup.

2-point Seat Belt +$0

5-point Harness Upgrade +$100

Shipping (calculated on your invoice)

Local pickup (in Central FL)

Payment Method: Please let us know your preferred payment method - We accept:
-PayPal (buyer pays associated services fees of 3.49% + 49¢)
-Credit/debit cards (buyer pays merchant services fees of 2.9% + 30¢)
-Zelle (no service fee. You will receive an invoice within 24 hours of sending payment).
If selecting PayPal, please let us know the address to invoice.

After reviewing our color options, please let us know which ones you would like for your bike chair attachment.
You can also leave any additional comments here as well.

Payment Choice

Paint & Seat Cover Colors

Please carefully read the below information. Do not check the boxes below or sign your name until you have fully read and agree to everything listed below. By checking the policy and waiver boxes, and signing below, you are acknowledging and agreeing to our terms and policies.

Refund & Return Policy: As each bike chair attachment is custom made-to-order, we do not accept refunds or returns. (All bike chair attachments are quality-checked prior to shipment. However, should any parts show defects or issues within 15 days of arrival, we will work closely with you and our manufacturers to try to the best of our ability to resolve the problem.) By checking this box, I acknowledge and agree to the Refund & Return Policy.

Liability Waiver: By checking this box, I understand and agree that Adaptive Bike Chairs, LLC is not responsible for any injuries that may occur while using or riding on an adaptive bike chair attachment ("The Product") made by Adaptive Bike Chairs, LLC. I acknowledge and understand the risks associated with riding on The Product, as well as the risks of riding on a bicycle while The Product is connected to the bicycle. I forever release and discharge Adaptive Bike Chairs, LLC, their affiliates, members, managers, volunteers, CEO, owners, and successors (collectively "Releasees") from any physical or psychological injury that I, or anyone who rides on The Product once it's in my possession, may suffer as a direct result of using The Product. I agree and understand the risks involved with using The Product which includes, but is not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand and acknowledge that these injuries or outcomes may arise from my own or others' negligence, as well as travel conditions while using the The Product. I assume all related risks, both known and unknown, even if arising from the negligence of the Releasees, while using The Product. I, and/or on behalf of my spouse, and minor child(ren)/ward(s) as well as on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS, Adaptive Bike Chairs, LLC and Releasees with respect to any and all illness, disability, death, or loss or damage to person or property, whether arising from the negligence of Releasees or otherwise, to the fullest extent permitted by law. I understand that I'm liable for any and all injuries that may occur once the bike chair attachment is in my possession.

Your Signature

Thanks for submitting! We will be in touch within 48 hours.

ORDER FORM As each bike chair attachment is made-to-order, we will need you to please fill out the below information. Once we've confirmed that we have all we need, we will send you an invoice for payment. Your order will not be placed in the production queue until payment has been received.

ORDER FORM

As each bike chair attachment is made-to-order, we will need you to please fill out the below information. Once we've confirmed that we have all we need, we will send you an invoice for payment. Your order will not be placed in the production queue until payment has been received.