Bike Request Form

Through a partnership with Free Bikes for Kidz, Big Brothers Big Sisters of the Midlands can distribute free bikes to kids in our program. If your Little/ Child needs a bike, please fill out the information below by Friday, December 2nd. Filling out this form does not guarantee that your Little/ Child will receive a bike.

BBBSM will fulfill bike requests on a first-come, first-served basis. Below is the sizing of the bikes.

6-10 years old 20" wheel size, 10-12 years old 24" wheel size, 12+ years old 26" wheel size

Family Information

Parent/ Guardian First and Last Name

Parent/ Guardian Phone Number

Parent/ Guardian Email

Child Information

Child's First and Last Name

Child's Age

Child's Gender

Child Bike Size (Please Reference Chart Above)

Nominator

Would you be able to pick up this bike on Saturday, December 3rd between 1PM-1:30PM at Children's Hospital off of 78th and Dodge?

If you are not a Parent/ Guardian of this child, please fill in your name below.

Contact Information