Please complete the online form below to register a bicycle with the Clayton Police Department. If you have any questions or concerns, please contact the Clayton Police Department at (302) 653-8186.

Personal Information

First Name:*

Middle Initial:

Last Name:*

Street Address:*

Apartment Number:

Subdivision:

City:*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip Code:*

Home Phone:

Alternate Phone:

Email Address:*

Birth Date:*

School or Employer:*

Parent or Legal Guardian:
(put N/A if over 18)*

Phone Number:
(put N/A if over 18)*

Bicycle Information

Make & Model:*

New or Used:*

New

Used

Serial Number:*

Frame:*

Boys

Girls

Brakes:*

Hand - Front or Rear

Coaster

Wheels:*

16 20 24

26 27 28

Color of Frame:*

Color of Fender:*

Accessories and Notes

Accessories:

Additional Notes:

Person Submitting Form:*

Date Submitted:*