EmailMe Form - Bike Service Intake Form ( rev.2.01/2022)

BIKE SERVICE INTAKE FORM
-- bike service will start April 30th, get in the queue to secure your spot! --
Name *
First Last
Phone *
### - ### - ####
Email *
Bike Info *

Type Brand Model Colour

Bike
Wheel/Tire size *
Look at the sidewall of your tire
Number of Front Gears *
Count the number of gears by your pedals
Number of Rear Gears *
Count the number of gears on the hub of your rear wheel
Send us a picture of the issue (optional)
Describe the problem *
Service Menu (short form) *
On a computer, hold down CTRL and select any line(s) that apply. On a mobile device, click to drop down the list and check off applicable items.
We will contact you if the repair cost exceeds this ESTIMATE by $40. Please proceed with this service. Replaced parts will be returned to you.
Signature: I accept the terms of this estimate *
Clear

	Type	Brand	Model	Colour
Bike