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Kuna City Bike Registration Program

2. Owner Name*

   Last, First, Middle Initial

3. Date of Birth

   Month/Day/Year

5. Address*

   Street Number & Street Name

6. Zip Code*

8. Owner Driver License Number/State

   If applicable

9. Home Phone*

10. Alternate Phone

12. Make/Brand

    EX: Schwinn, Trek, Redline

13. Model Name or Number

15. Style

    Mountain Bike, tandem

16. Wheel Size

17. Speed/Gears

18. Frame size

20. Color(s)

21. Brake System

    EX: Hand or Pedal

22. Serial Number*

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field