4.8. Clinician/ATP/RTS: City: State/Prov: Marked for: Phone: * Required KDMA063 English Manual (STD) Manuel Français

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1 160 Armand-Majeau Sud Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T F P.O. number:* Date: Ship to:* Company Name:* Phone:* Name: Helio KIDS ORDER FORM - INTERNATIONAL Ordered by:* Address: Clinician/ATP/RTS: City: State/Prov: Postal/Zip Code: Marked for: Phone: * Required KDMA063 KDMA068 English Manual () Manuel Français Taxes not included MODEL 1 KDWC06 Ultralight Folding Carbon Fiber Helio KIDS Wheelchair Including angle & depth adjustable back (79,4 kg lb weight capacity) 2 KDWC10 E-Motion adaptor Kit (2 adaptors) $72 FREE Growth Kit within the first 5 years of the Helio KIDS wheelchair ownership The growth kit includes carbon crossbraces, crossbrace links, seat sling, back upholstery, front riggings and footplates. SEAT WIDTH 1 3 KDSW12 Seat width: 30,5 (1) 33,0 (13") 35,6 () 38,1 () 40,6 () SEAT DEPTH (Seat sling and frame have a fixed depth for improved rigidity and reduced weight) 4 KDSD14 30,5-38,1 cm (12-) (35,6/ seat sling/frame) 5 KDSD ,6 cm (13-) (38,1/ seat sling/frame) 6 KDSD16 35,6-43,8 cm (14-) Seat depth adjustment achieved by (40,6/ seat sling/frame) changing back cane position 7 KDSD17 38,1-45,7 cm (15-) (43,8/ seat sling/frame) 8 KDSD18 40,6-48,3 cm (16-) (45,7/ seat sling/frame) 1. Width Calculator $3 790 Forks / Position 4" 10,2 cm P1 P2 P1 33cm / 13" 34,3cm / 13,5" 3" caster 4" caster 34,3cm / 13,5" Helio Kids FRONT Seat-to-floor Height - Please select your choice 5" caster 6" caster 7" caster 8" caster 5" 12,7 cm 7" 17,8 cm P2 P3 P4 P1 P2 P3 P4 P5 Height available +- 0,65cm (1/4") (see stem bolt and fork combination at the end of the order form) 53,3cm / 2 53,3cm / 2 54,6cm / 21,5" T F HELIO KIDS Orderform INT 4.8 September 21, of 6

2 CASTERS 9 KDCA01 Composite wheel w/ PU tire ( width) 3" 4" 5" 6" 7" 8" 10 KDCA10 Pneumatic 6" x 1 ¼" $ KDCA11 Pneumatic 8" x 1 ¼" $ KDCA14 4" x 1 ½ " $80 13 KDCA15 Newton UltraCaster Soft-Roll Composite 5" x 1 ½ " $80 14 KDCA16 6" x 1 ½ " $80 15 KDCA17 4" x 1 ½ " $ KDCA18 Newton UltraCaster Soft-Roll Aluminum 5" x 1 ½ " $ KDCA19 6" x 1 ½ " $195 CASTER OPTIONS 18 KDCA12 Caster Pin Locks (Available with + or + Stem bolt ONLY) $ KDCA13 Frog Legs suspension forks phase-one (Not available with caster pin locks) Specify weight of user: $475 WHEEL SIZES wheel 2 wheel 24" wheel KIDS REAR Seat-to-floor Height Height available 31,8cm / 12,5" to 43,8cm / 17,25" Specify desired height: 34,3cm / 13,5" to 46,4cm / 18,25" to 48,9cm / 19,25" Note: Tire size, center of gravity setting and seat slope may result in a variation of +/- 1cm of selected seat to floor height" SWING-IN/SWING-OUT FOOTREST 20 KDFR03 60 Swing-in/swing-out see line 23 (12,7-34,3cm/5-13,5") 34,3-43,2cm/13,5-36,8-49,5cm/14,5-39,4-52cm/15,5- * 21 KDFR04 70 Swing-in/swing-out see line 23 (12,7-34,3cm/5-13,5") 34,3-43,2cm/13,5-36,8-49,5cm/14,5-39,4-52cm/15,5- * 22 KDFR15 80 Swing-in/swing-out see line 23 (12,7-34,3cm/5-13,5") 34,3-43,2cm/13,5-36,8-49,5cm/14,5-39,4-52cm/15,5- * FOOTREST OPTIONS 23 KDFR09 High mount (footplate attached to the hanger with clamps) Range: 12,7-34,3cm/5-13,5" * $ Non standard length modification option for standard 60, 70 and 80 footrests * +/- 1/ ( 1,2 cm) 90 SWING-IN/SWING-OUT FOOTREST WITH FRONT MOUNT (Footplate mounted to hanger tube) 24 KDFR06 90 swing-in/swing-out with front mount - Standard (no extension) cm (7.5-1) * 25 KDFR07 90 swing-in/swing-out with front mount - Short extension 1, cm (9.5-13") * 26 KDFR08 90 swing-in/swing-out with front mount - Medium extension 4" 1, ,8cm ( ") * 27 KDFR99 Omit Footrest 1 - Available only with adjustable footplates 2 - May interfere with front casters * +/- 1/ ( 1,2 cm) ELEVATING LEGREST (unit) The elevating legrest replace the footrest side selected 28 KDFR10 Elevating legrest with calf pad, 35.5 to 48.3 cm length adjustable Left Right * $240 * +/- 1/ ( 1,2 cm) FOOTPLATES 28 KDFP01 Standard - Composite 29 KDFP02 Newton adjustable angle - Composite $ KDFP03 Newton adjustable angle - Aluminum 1 $ KDFP04 Newton adjustable angle - Carbon fiber (with rubber inserts) $ KDFP05 Newton adjustable angle extra deep - Aluminum $ KDFP06 One piece adjustable angle flip-up - Aluminum. (Not available with 90 Front Mount) $ KDFP07 One piece adjustable angle flip-up - Carbon fiber. (Not available with 90 Front Mount) $435 FOOTPLATE ACCESSORIES 35 KDFP08 Length adjustable heel loop (not available with one piece footplate) $40 36 KDFP09 Calf strap $35 37 KDFP30 Bodypoint Aeromesh Padded calf strap $ The Newton adjustable angle (Aluminum) is the only available option with a 12 and 13" wide frame RESIDUAL LIMB SUPPORT (Height and angle adjustable) (unit) 38 KDFR23 Swing away residual limb support - 18,8 x 22,8 cm (7" x 9") Left Right $ KDFR12 Swing away residual limb support x 27.9 cm (8" x 1) Left Right $375 T F HELIO KIDS Orderform INT 4.8 September 21, of 6

3 Back canes, depth ajustable and angle ajustable, with option BACK CANES - Depth ajustable and angle ajustable 40 KDBC15 Straight aluminum back cane 22,9-30,5 (9-1) 30,5-38,1 (12-) 38,1-45,7 (15-) 45,7-53,3 (18-2) 41 KDBC16 8 Bend Aluminum back cane 30,5-38,1 (12-) 38,1-45,7 (15-) 45,7-53,3 (18-2) 42 Select back cane angle: Set height to: 1 (measured from seat sling to top of back upholstery) 1 - If not indicated, default height setting is at the lowest position PUSH HANDLE OPTION 43 KDPH01 Push handles 44 KDPH05 Fold down push handles 2 $ KDPH02 Without push handles 2 - Not compatible with stroller handle, stabilizer bar and headrest and attendant lock STROLLER HANDLE AND STABILIZER BAR 1 (only available with push handle) 46 KDPH04 Stroller handle $ KDPH03 Newton folding stabilizer bar $ Stroller handle and stabilizer bar can't be combined BACK UPHOLSTERY 48 KDBH07 Slip-on Active-Mesh back upholstery 49 KDBH08 Adjustable tension Active-Mesh back upholstery $ KDBH99 Omit Back upholstery SEAT CUSHION 51 KDSC cm () Cushion $ KDSC cm (3") Cushion $ KDSC99 Omit Cushion REAR WHEELS 54 KDRW01 Mag " $50 55 KDRW02 Newton One - spoke wheel " 56 KDRW03 Newton Gravity - ultralight wheel 2 24" $ KDRW04 Spinergy Spox 2 24" $ Spinergy Spox spokes colors 1 Blk Wht Blue Red Yel 59 KDRW05 Spinergy LX 2 24" $ Spinergy LX spokes colors 1 Blk Pur Wht Blue Red Yel Pink Grn Org 61 KDRW07 Spinergy CLX Carbon Blade 24" $ Spinergy CLX spokes colors 1 Blk Pur Wht Blue Red Yel Pink Grn Org 1 - Colour spokes require an additionnal 10 days lead-time 2 - HP tires are not compatible with Mag Wheels -use only aluminum or plastic coated handrim 3- Not compatible with Shox tires TIRES Available 63 KDTI01 Soft Urethane 1 1/4 ", 2 24" 64 KDTI02 Soft Urethane knobby 1 3/8 " 2, 24" $95 65 KDTI04 Soft Urethane - Shox 2, 24" $ KDTI05 Pneumatic 1 3/8 ", 2 24" 67 KDTI08 Pneumatic 1 3/8" with Airless insert 2, 24" $80 68 KDTI06 Pneumatic HP -, 2 24" $95 69 KDTI07 Pneumatic HP - Schwalbe Marathon Plus 1'' 24" $125 T F HELIO KIDS Orderform INT 4.8 September 21, of 6

4 HANDRIM 70 KDHR01 Aluminum anodized 71 KDHR07 Newton Air Grip 1 Black $95 Newton Air Grip 1 (08) Sunkissed Orange (09) Burgundy (10) Sapphire Blue 72 KDHR08 (11) Monster Green (12) Charcoal (13) Fuchsia (14) Steel Blue $240 (15) Ferrari Red (16) Acid Green (17) White (18) Sky Blue Assembly position for aluminum and Newton AirGrip handrims 73 C2HR29 Standard Handrim position Full tab 74 C2HR30 Narrow Handrim position (not available in 2) Short tab 2 positions $25 75 C2HR31 Super Narrow Handrim (not available in 2) Short tab 2 positions Short tab 1 position $25 HANDRIM 76 KDHR02 Plastic coated 3 $95 77 KDHR03 Q-Grip High friction Neoprene coated 1, 2, 3 $ KDHR28 Surge 1, 2, 3 (1-1/ Oval handrim w/ Gripton high friction strip) $ KDHR05 Surge LT 1, 2, 3 (1-1/8" Oval handrim w/ Gripton high friction strip) $ KDHR04 Natural Fit* Standard Grip 2,3 (1-1/ Oval handrim w/standard thumb piece) $ KDHR25 Natural Fit* Super Grip 2,3 (1-1/ Oval handrim w/super grip thumb piece) $ KDHR99 Omit handrim 1- Not available with Mag wheels 2 - Not available in 3- Only standard handrim position available ONE ARM DRIVE 83 KDHR22 One arm drive 4 24" left right New $ Only available with Newton One wheels ; only available with aluminum or plastic handrims AXLE 84 KDAX01 Quick release axle 85 KDAX02 Permanent axle 86 KDAX03 Quad release axle $125 AXLE PLATE 87 KDAX04 Amputee adjustable axle plate 1 $ May interfere with swing away armrest and limit seat to floor height available REAR WHEEL CAMBER 88 KDCM00 0 camber 89 KDCM03 3 camber 90 KDCM06 6 camber (not available with amputee axle plate) $150 CENTER OF GRAVITY Choose position of rear wheel axle plate: Measure distance X from front of back post to center of axle receiver. Most stable Most responsive X = 2,5 3,2 3,8 4,4 5,1 5,7 6,3 7 7,6 8,3 8,9 9,5 4" 1/4" 1/ 3/4" 1/4" 1/ 3/4" 3" 1/4" 1/ 3/4" If not indicated, default setting is at 3,8 cm (1.5 ) Possible conflict between a seat depth under 40.6 cm () and a center of gravity over 6,3 cm (2.5"). Possible conflict between a 66 cm (26") rear wheel and a center of gravity over 6,3 cm (2.5"). If a configuration issue arises due to the choice of the Center Of Gravity (COG) reserves the right to reduce or increase the COG to the closest position. WHEEL LOCK 91 KDWL08 Newton Wheel lock - push to lock 92 KDWL02 Pull to lock 93 KDWL04 Newton grade aid push to lock (suggested with pneumatic or high pressure tire) $ KDWL13 KDWL14 6" removable extension handle $75 95 KDWL05 Scissor Lock $ KDWL06 Attendant Lock (additional set of wheel lock mounted to the back) $ KDWL99 Omit wheel locks T F HELIO KIDS Orderform INT 4.8 September 21, of 6

5 "T" ARMREST 1 Height Adjustment 98 KDAR03 10" Desk length arm pad 20-30cm (8-1) 25-36cm (10 - ) $ KDAR04 Full length arm pad 20-30cm (8-1) 25-36cm (10 - ) $ May have a 1/2 " adjustment restriction on both limits of the range LOCKING FLIP-UP ARMREST KDAR07 Locking Flip-Up Armrest Set height to: $330 GEL ARM PAD 101 KDAR12 14'' Full Length Arm Pad - Gel Ovation $ KDAR99 Omit armrest 2 - May interfere with rigid back hardware 2 - Only available with - 2 straight aluminum back canes 2 - Not available with a back upholstery SIDE GUARDS (not available with "T" Armrest) 103 KDSG01 Plastic side guards (removable) $ KDSG03 Carbon fiber side guards (removable) $ KDSG06 Plastic fender side guards (removable) 1 $ KDSG04 Carbon fiber mud guards (removable) $ KDSG99 Omit side guard 1 - Not compatible with and 2 rear wheels POSITIONING BELT 108 KDSB01 Velcro adjustable Standard 88,9 cm/35" Long 152,40 cm/60" $ KDSB02 Auto buckle Standard 88,9 cm/35" Long 152,40 cm/60" $ KDSB07 Hardware attachment for 2 point seatbelt (1 pair) 111 KDSB03 Additional hardware for 2 extra attachment points (needed for the 4 point seat belt) (1 pair) $ KDSB04 BodyPoint Hip Belt - 2 point not padded M (142,24 cm/56") L (154,94 cm/6) $ KDSB05 BodyPoint Hip Belt - 2 point padded S (129,54 cm/5) M (142,24 cm/56") L (154,94 cm/6) $ KDSB06 BodyPoint Hip Belt - 4 point padded S (129,54 cm/5) M (142,24 cm/56") L (154,94 cm/6) $ KDSB08 BodyPoint EVOFLEX Positioning Belt Rehab latch and Band Clamps M (73,66 cm/56") L (93,98 cm/6) $ KDSB99 Omit positioning belt HEADREST KDAC01 Profiled Headrest Small (3,5"X6") Medium (4,5"X7") Large (5,5"X8") $ KDAC02 Headrest mounting hardware with removable non folding stabilizer bar $ Only available with push handles - Not available with a stroller handle or a folding stabiliser bar ACCESSORIES 119 KDAC03 Anti tippers $ KDAC27 Tip assist 1 New $ KDAC04 Transit Tie Down (Unoccupied) 122 KDAC06 Cane carrier Left Right $120 Oxygen tank holder - E Type 123 KDAC07 Left $310 Not compatible with swing away armrest or amputee axle plate 124 KDAC08 Spoke guards 2 Available:, 2, 24" $ KDAC09 Footrest neoprene impact guard (pair) - Black $ KDAC10 Seat pouch $ KDAC23 Newton Backpack $ KDAC26 BodyPoint Mobility Bag $ KDAC12 Velcro Closing Strap $ KDAC13 Tool kit $45 W/S W/M W/L 131 KDAC16 Polo Shirt $32 M/S M/M M/L M/XL M/XXL M/XXXL M/XXXXL 1 - Cannot be combined with Anti Tippers 2 - Not available with Mag wheels FRAME COLOR (with carbon finish crossbrace) 132 KDFC01 Carbon Fiber Black 133 KDFC03 Sunkissed Orange Burgundy Sapphire Blue Monster Green Charcoal Fuchsia Steel Blue Ferrari Red Acid Green 134 KDFC99 Custom Color Specify PPG Paintit color: $360 TOTAL NC T F HELIO KIDS Orderform INT 4.8 September 21, of 6

6 Fork and Stem bolt combinations Notes : T F HELIO KIDS Orderform INT 4.8 September 21, of 6