Bicycle Registration

* Indicates field is required.

* Last Name:

* First Name:

Email:

* Phone #:

* Address:

* Bicycle Make:

Bicycle Model:
* Serial #:

* Type:
* Color:

School:

In registering this bicycle, I certify that the serial number entered is the same number as stamped on the bicycle owned by me, and that the bicycle is equipped with a working headlight, brakes and a red reflector showing to the rear of the bicycle, all in conformity with City of Oshkosh Municipal Code Section 27-64.