Bicycle Registration Form

It's fast! Convenient! Super Easy! Receive a small, aluminum Security ID tag. Once placed on your bike it's almost impossible to remove! *Suggested Donation: $1.00

Please provide your Contact Information

Please provide information about your bicycle

Condition of your Bicycle?

Frame Style?

Please select the items installed on your bike.

Would you like a security ID tag?

Other remarks, comments, or questions

Please enter any other information you would like to share in the area below.

*Our $1.00 (per bike) suggested donation will help fund this program.
Please send $1.00 cash or check to:
Crime Prevention of West Palm Beach, Inc.
600 Banyan Blvd West Palm Beach, Fl. 33401

To prevent Spam, we require you to enter in a confirmation code. Please enter the text in the field below:
Can't make out the text in the image? Click here

Please click only once!

Please note: Information collected through this form is intended for use by the West Palm Beach Police Department and not for distribution to third parties.