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

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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.