Order Form

PO Box 112044 • Anchorage, Alaska • 99511
Ph: 907-529-8833 • Fax: 907-344-6600
Update: 1-1-12
Ordered By / Ship To
Name: __________________________________________________
Address: _________________________________________________
City: _______________________ State: ______ Zip: ____________
Phone Number: ___________________________________________
e-Mail Address: ___________________________________________
Height:________ Weight:________ Age:_________ Injury: _______
Shirt Size:___________ Current Handcycle: ____________________
By signing below, you acknowledge that you understand all measurements and options on this order form and confirm that they are correct.
You also acknowledge that your handcycle will be custom made to these specifications for you and that there are no refunds or exchanges.
Customer Signature: _______________________________________
Frame StyleLasher Sport ATH- All Terrain Handcycle
$ 4995.00
Magnesium Frame, Aluminum Fork
Options Cost
$_______
Shipping (US)
$ 695.00
Total Cost*
* A 50% deposit is required at time of order.
$_______
Frame Dimensions
1- Seat Width- 14”-18” by 1”: __________
2- Seat Depth- 14”-18” (adjustable) by 1”: __________
3- Back Rest Height- 12”-20” (fixed height) by 1” : __________
4- Back Rest Angle (relative to ground)- adjustable- 70°-90°: __________
5- Wheel Camber: 6° standard
6- Rear Wheel Width (fixed width): 30”
7- Footrest- adjustable tube, ankle padded sling with Velcro loop enclosure.
8- Back Rest Upholstery: Tension strap with 1.5” foam padding – Standard
9- Seat Upholstery: Tension strap– Standard
Crank Arms10- Crank Arm Length- Select one
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7.0” (18cm)
7.25” (18.5cm)
7.5” (19cm)
7.675” (19.5cm)
7.875” (20cm)
8.0” (20.5cm)
8.25” (21cm)
8.5” (21.5cm)
8.65” (22cm)
Other: ____________
11- Crank Arm Width- Select one
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20” (51cm)
21” (53.5cm)
22” (55.75cm)
23” (58.5cm)
24” (61cm)
25” (63.5cm)
26” (66cm)
27” (68.5cm)
28” (71cm)
Other: ____________
Crank Height12- Fixed Crank height (relative to top front of seat rail)- Standard
Seat cushion is recessed between frame rails approx. 1”
 13” (33cm) crank height
 14.5” (36.75cm) crank height
 13.5” (34.25cm) crank height
 15” (38cm) crank height
 14” (35.5cm) crank height
 15.5” (39.25) crank height
Fork Style Basic Fork- Standard
* The Basic Fork can accommodate the following wheel
Sizes: 26” mtn bike, 650c road bike
 Optional - Universal Fork- $395
* The Universal Fork can accommodate the following wheel
Sizes: 26” mtn bike, 29” mtn bike, 650c road bike, 700c road bike, 26” x 3.8” winter/beach tire (offset)
Components- (see component guide for information and descriptions.)
Shifters
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Shimano SLX 10-speed Shifter Set- Standard
Optional- Shimano XT 10-speed Shifter Set- $155
Optional- Shimano XTR 10-speed Shifter Set- $275
Optional- Other:______________________- $TBD
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Shimano CS-HG62- 10-speed 11-36T- Standard
Optional- Shimano XT 10-speed 11-36T- $ 125
Optional- Shimano XTR 10-speed 11-36T- $ 285
Optional- Other:______________________- $TBD
Cassette-
Crankset & Bottom Bracket Shimano Deore (24-32-Bash)- Standard
 Optional- Shimano SLX (24-32-Bash)- $ 195
 Optional- Shimano XT (24-32-Bash)- $ 295
 Optional- Shimano XTR (24-34-Bash)- $ 595
 Optional- Other:______________________- $TBD
Chainring Upgrade None - Standard
 Inner Chainring- 20T titanium- $195
Front Derailleur Shimano SLX - Standard
 Optional- Shimano XT - $ 65
 Optional- Shimano XTR - $ 115
 Optional- Other:______________________- $TBD
Rear Derailleur Shimano Deore- Standard
 Optional- Shimano SLX- $55
 Optional- Shimano XT- $125
 Optional- Shimano XTR Shadow w/ Stabilizer- $255
 Optional- Other:______________________- $TBD
Chain
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Shimano SLX- Standard
Shimano XT- $45
Wipperman ConneX 10sX Stainless- $ 115
Wipperman ConneX 10s1 Stainless- $ 175
Optional- Other:______________________- $TBD
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Cane Creek 40- Standard
Cane Creek 100- $ 75
Cane Creek 110- $ 135
Optional- Other:______________________- $TBD
Headset-
Wheels- (see wheel & tire guide for information and descriptions.)
Front Wheel (Drive wheel)Wheel Type
 WTB 26” (559) Speed Disc with 6-bolt Disc Brake Mount- Standard
 Optional- Spinergy 26” (559) Xyclone Disc with 6-bolt Disc Brake Mount - $ 395.00
 Optional- Spinergy 29er (622) Xyclone Disc with 6-bolt Disc Brake Mount - $ 495.00
Tire Type- optional price is for one tire
 Schwalbe Albert- Standard
 Optional- Schwalbe Racing Ralph- $ 74.00
 Optional- Schwalbe Nobby Nic- $ 74.00
 Optional- Schwalbe Muddy Marry- $ 64.00
 Optional- Schwalbe Dirty Dan- $ 74.00
 Optional- Schwalbe Ice Spiker Pro- $ 134.00
Rear WheelsWheel Type
 26” (559) Spinergy Wire Wheel w/ handrim, quick release axle, pair- Standard
 Omit Handrim- NCO
 Optional- 26” (559) Spinergy SLX 24 Spoke Wheel w/ handrim, quick release axle, pair- $ 595
 Omit Handrim- NCO
 Optional- Lasher Spec, Spinergy Xyclone Disc 26” (559) with 6-bolt Disk Brake Mount, ½” threaded axle, pair- $ 895
 Optional- Lasher Spec, Spinergy Xyclone Disc 29er (622) with 6-bolt Disk Brake Mount, ½” threaded axle, pair- $ 995
Tire Type- optional price is for two tires
 Schwalbe Albert- Standard
 Optional- Schwalbe Racing Ralph- $ 148.00
 Optional- Schwalbe Nobby Nic- $ 148.00
 Optional- Schwalbe Muddy Marry- $ 128.00
 Optional- Schwalbe Dirty Dan- $ 128.00
 Optional- Schwalbe Ice Spiker Pro- $ 268.00
Brakes- (see Brake guide for information and descriptions)
Parking Brake (front wheel mounted mechanical disc brake w/ lockout) Avid BB 5 160mm Disc Brake- Standard
 Optional- Avid BB 7 160mm Disc Brake- + $65
Front Wheel Avid Elixir 1 160mm Hydraulic Disc Brake- Standard
 Optional- Avid Code R 160mm Hydraulic Disc Brake- + $195
 Optional- Avid Code 160mm Hydraulic Disc Brake- + $285
 Optional- SRAM X0 160mm Hydraulic Disc Brake- + $345
 Optional- SRAM XX 160mm Hydraulic Disc Brake- + $375
Rear Wheels- optional price is for a pair of disc brake calipers and lever, requires Spinergy Xyclone Disc rear wheels
 None- Standard
 Optional- Tektro Dual hydraulic Disc Brake- $995
Frame Finish- (see the Color Chart at the end of this form for color samples)
Standard Powder Coat Colors:
(all are gloss except where noted)
 Clean White
 Ink Black
 Flatter Black (Matte)
 Anthracite
 Cherry Bliss
 Vampire Red
 Astatic Red
 Chevy Orange
 Caterpillar Yellow
 Racer Green
 Signal Green
 Fern Green
 Army Green (Matte)
 Delta Green
 Dunbar Blue
 Flyer Blue
 Sinbad Purple
 Whimsy Pink
 Wild Pink
Optional- Metallic
Powder Coat Colors: +$295
 Cosmic White
 Black Metallic
 Misty Lava
 Seaside Bronze
 Alien Silver
 Lazer Marmalade
 Misty Copper
 Burgundy Flare
 Cosmic Red
 Russet orange
 Yellow Mirage
 Lazer Emerald
 Misty Aquarius
 Sage Teal Sparkle
 Misty Midnight
 Reflex Blue
 Cream Soda Blue
 Seascape Blue
 Purple Mirage
 Plum Crazy
Optional- Sparkle & Illusion
Powder Coat Colors: +$395
 Shattered Glass over Ink Black
 Seattle Lights over Ink Black
 Moondust Orange over Ink Black
 Clear Vision over Illusion Copper
 Lollypop Red over Alien Silver
 Nugget Gold over Harley Orange
 Moondust Lime over Spring Yellow
 Clear Vision over Illusion Green
 Ultra Blue Twilight over Ink Black
 Clear Vision over Illusion Light Blue
 Teal Clear over Ink Black
 Emerald Sparkle over Sinbad Purple
 Moondust Green over Sinbad Purple
 Clear Vision over Illusion Purple
Optional- Deep Transparent
Powder Coat Colors: +$495
 Smoked Nugget
 Liquid Smoke
 Oxblood Ransom
 Wilder Red
 Coppertone
 Tangelo Glaze
 Psycho Lemon
 Psycho Green
 Dewy Green
 Aurora Blue
 Dazzling Blue
 Lollypop Grape
 Misled Red
 Summer Punch
Optional AccessoriesAdditional Wheel Sets Winter/Beach 26” (559) with 6-bolt Disc Brake Mount (Drive Wheel)- Requires Universal Fork
 With drive wheel disc brake and QR rear hubs- $1995
 With drive wheel disc brake and threaded rear hubs- $2495
 Road 650c Spinergy Stealth with 6-bolt Disc Brake Mount (Drive Wheel) and threaded axles- $2495
 Front Wheel Fender- $95
 Seat Belt- Click strap, frame mounted- $95
 Visibility Flag and Mount- $95
Head lights CygoLite MityCross 350, LED Light, 350 lumens, 3.5-17 hr rechargeable Li-Ion - $239
 CygoLite Triden Xtra, LED Light, 600 lumens, 5-25 hr rechargeable Li-Ion - $399
Tail LightsCat Eye LD610, 5 LEDs, 30- 60 hrs- $39
Cat Eye LD1100, 10 bright LEDs, up to 100 hrs- $49
Cycling Computer Systems (unmounted) Sigma BC1009 STS Wireless Computer- $69
 Sigma BC1609 STS Cad Wireless Computer- $94
 Sigma BC2209 STS MHR Triple Wireless Computer- $149
 Sigma ROX 9.0 Wireless Computer- $249
 Garmin Edge 500 Bundle w/ HR-Cadence- $249
 Garmin Edge 605- $399
 Mount and Configure cycle computer- $95
High Definition wearable/mountable Video Camera
 Contour HD- $279
 Contour HD GPS w/ Bluetooth- $349
 Contour XL handlebar mount- $30
 Contour vented helmet mount- $30
 Camelback Hydration System, 70oz.- $95
 Lasher Sport Multi-Use Storage Bag (rear frame mount)- $295
Seat Cushion Jay Basic, 2”- $149
 Custom Cushion, specify make and model- __________________________ $TBD
Additional Instructions & Special Requests:
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