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Bicycle Registration Form
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This form has been modified since it was saved. Please review all fields before submitting.
Owner Information
First Name
*
Last Name
*
Address
*
City
*
State
Zip Code
Phone Number
*
Email Address
*
Bicycle Information
Make
*
Model
*
Color
*
Type
*
Speed
*
Serial Number
*
Approximate Value
*
Location Purchased
*
Select One
*
-- Select One --
Male
Female
Other Identifying Features
Upload Picture of Your Bicycle
Terms and Conditions
By Checking the box below, I certify that the bicycle I am registering belongs to me and was obtained legally. I will provide such proof upon request. I understand that registering my bicycle through the Napa Police Department bicycle registration program is not a guarantee that my bicycle will be protected from theft or loss. Instead, the purpose of registering my bicycle is that the information I supply on the form may be used to contact me in the event the Police Department recovers my bicycle after a theft or loss.
I agree to the terms listed
*
Yes
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