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    Is this Bike Shop an On-line Only Shop: YesNo *

    Bike Shop Name: *
    Bike Shop Phone Number: *
    Street Address:
    State or Province:
    Country: *
    Zip or Postal Code:

    Bike Shop Web Site:
    Bike Shop E-mail Address: *

    Contact Name: *
    Contact Phone Number: *
    Contact E-mail Address:

    What are the hours of business?

    Do you have a BMX Mechanic on staff doing repairs? YesNo *

    If Yes, Do they work the same hours as business hours? YesNo

    If No, what are their normal hours of work?

    Special Comments

    You can also upload any Bike Shop photos, logos, flyers, or other stuff that you would like us to add to the BMX Bike Shop page.

    Photos or Logos (Acceptable: .gif; .jpg; .jpeg)

    Flyers (Acceptable: .pdf; .doc)

    Other or Extra (Acceptable: .jpg; .jpeg; .gif; .pdf; .doc)

    The following information will not be added to the BMX Bike Shop information page but is needed for verification purposes.

    Your Name: *
    Your E-mail Address: *

    Would you like to join our Newsletter? YesNo *

    Remember that all items marked with a * are required items.


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