Birmingham AMBUCS

Downloadable Forms

Important Note: Before a rider is placed on the Wish List, they are required to fill out the form below. All pages must must be printed and mailed or filled out, scanned, and emailed to Birmingham AMBUCS.

Application Form

Fill out the attached application form with the help and guidance of a physical therapist. Then, send the application to AMBUCS with a $100 required donation.

Steps to Receive an AmTryke Adaptive Tricycle

The PDF linked below has additional instructions and the 5 steps required for receiving an AmTryke Adaptive Tricycle for kids. Contact us with any questions.