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Bicycle Registration Form
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First Name
*
Last Name
*
Address1
*
City
State
Zip
Contact Number
*
email
Manufacturers Serial Number
*
Bicycle Make
*
New or Used Bicycle
New
Used
Frame Color
*
Frame Type
*
-- Select One --
Double Bar Frame
Signle Bar Frame
Other
Bicycle Model
Boys or Girls Style Bike
Boys Style
Girls Style
Brakes
Front
Rear
Front and Rear
Coaster Bike
Wheel Size
*
-- Select One --
16 Inch
18 Inch
20 Inch
21 Inch
24 Inch
26 Inch
27 Inch
28 Inch
Seat Make
My bike has
Front Fender
Rear Fender
Rim Color
Fender Color
Accessories
Front Light
Rear Light
Locking Device
Reflectors
Front Basket
Rear Basket
Describe any other accessories
Distinguishing Characteristics about the bike (please be detailed)
Please Note:
Florida has a very broad public records law. Most written communications to or from the Town of Jupiter officials and employees regarding public business are public records available to the public and media upon request. Your e-mail communications may be subject to public disclosure. Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
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