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Nomination Form
First Name
Last Name
Email
Phone
What are your needs
Helmet
Bike
Both
Why does this child deserve a Bailey's Bike
How tall is the child
Do you have an outgrown bike to donate?
Yes
No
Anything else you would like to add?
Have you read and accept our saftey/helmet and photograph policies?
Yes we accept terms and conditions
No
Submit
Thanks for submitting!
T&C
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