Brilliant Bike Request
WHOOHOOO! Thank you so much for your interest in snagging a Brilliant Bike for your kiddo(s). Bikes (and gear) will be delivered to you just before the holidays of 2024 so they have a fantastic surprise waiting for them. We will do our best to fulfill all requests, but can not guarantee a bike. This program is designed for youth in Blaine and Birch Bay, WA whose families would otherwise not have the financial opportunity to buy them a bike and gear, so we ask that you only apply if that pertains to you. THANK YOU! We can't wait to meet you. *Please Note: We will never spam you or sell your data. All of your information will be kept 100% confidential.
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Email *
Contact info
Parents Name  *
Phone number *
Preferred contact method *
Required
How many bikes are you applying for? *
Required
Kid's Name(s)  *
Height and Weights of Kid(s) *
Please give us the most accurate information possible for each child you are applying for to make sure we can accommodate to the closest fit. 
Besides a bike, there are other things needed for bike riding and maintenance. Please check which ones you would also like to apply for (we can not guarantee it, but will do out best!) *
Please select all that apply:
Required
How would having a bike improve your child's life? *
Why do you want a bike for your kid(s)? *
Please select all that apply:
Required
Do you have color preferences?  *
We will do our best to accommodate, but we can not guarantee it.
Required
Upon being selected, you will have to provide proof that your child lives in Blaine or Birch Bay with something like a utility bill, a lease, etc. Are you able to provide proof? *
Do you agree to pass the bike along to another child, whether in your family or community, when your child outgrows it? *
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