Bicycle Registration Form


REGISTRATION TAG #
__________________                              Date: ______________________
                      
                             (To be filled in by staff)


 Owner Name: ________________________________         Phone #: ______________________


 Address: ____________________________________         Alt Ph #: ______________________

 City/State/Zip: ________________________________
 

Description of Bicycle:

Make: ___________________________________                   Model: ________________________

Serial Number: __________________________________________________________________

Owner Applied Number: __________________________________________________________

Type: _______________________                                           Wheel Size: _____________________ 

Speeds: __________________________________         Frame Color: ______________________

Condition/Other: ________________________________________________________________

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