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2. Canton Police Bicycle Registration
4. First Name
5. Last Name
7. Address1
9. City
10. State
11. Zip
13. Home Phone
14. Additional Phone
15. Email Address
17. Brand
18. Color
19. Model
20. Style
22. Size
23. Gears
24. Serial No.
26. Check Type

    1. Boy's
    2. Men's
    3. Girl's
    4. Women's
27. Value $
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29. 1. Receive an email copy of this form.
30. Email address

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