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2. Bicycle Registration Form
4. This online program is free. If you are a Marina resident and wish to participate, please complete the information on this form. Fill out all required fields. Upon receipt of the completed form, you will be issued a registration sticker, application instructions, and safety information.
6. Personal Information
8. Last Name:*
9. First Name:*
10. Date of Birth:
    Date of Birth:
12. Street Address:*
13. City:*
14. Phone Number:*
16. Bicycle Information
18. Brand:*
19. Model:*
20. Serial Number:*
21. Color:*
23. Speeds:*
24. Approx. Purchase Date:
    Approx. Purchase Date:
25. Where Purchased:
26. Approx. Value
28. This registration program is not intended to stop bicycle theft, but rather to act as a deterrent. Registration makes it easier to track stolen property (by serial numbers) and speeds up the process of returning bicycles to their rightful owners. For further information, please call (831) 884-1210 or email us at bikereg@cityofmarina.org.
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field