Please attach a photograph of the bicycle with this form. Thanks.

Owner Name:*

Date of Birth:*

Parent/Guardian:*

Address:*

Phone:*

Bicycle Make / Model:*

Bicycle Size / Color:*

Bicycle Serial #:*

Bicycle Value:

Picture of Bicycle:

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

If your bicycle is lost or stolen, please contact the Brighton Police Department:
3401 E. Bromley Lane, Brighton, CO 80601 (303)655-2300