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Bicycle Registration

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Name

Last   First   Middle Initial

Address

Street

City   State   Zip Code

S.S. #

Telephones

Home   Work

Bicycle

Make   Model

Color   Year

Wheel Size   No. of Speeds  

Frame Type: Sex

Serial Number

Accessories/Unusual Characteristics

Purchased From

Store

Street

City State Zip Code

Date of Purchase

 

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For information about this web site, contact Colonel Kenneth C. Hughes, Jr.