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Bicycle Registration Form

2. Bicycle Registration Form

3. 

5. CONTACT INFORMATION

7. Name*

8. Email Address*

10. Address*

12. City*

13. State*

14. Zip Code*

16. Phone Number*

18. BIKE INFORMATION

20. Serial #:*

22. Make:*

23. Model:*

25. Size:*

    1. Small

    1. Medium

    1. Large

26. Type:*

    1. Boys
    2. Girls

28. Bike Color:*

30. ONCE RECEIVED, SKOKIE PD STAFF WILL MAIL YOUR REGISTRATION STICKER WITHIN 5 BUSINESS DAYS
    Please call 847/933-5932 if you have any questions.

    Please call 847/933-5932 if you have any questions.

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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

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