Bikeshield.bike Registration

Policy Registration UB

info@bikeshield.bike 1-888-988-6443
Currently, Bikeshield.bike policies are only available for the United States of America

Before you start, please have ready

-          Picture or file of purchase receipt

-          Picture of the bicycle with a clean back ground

-          Picture of the frame number

-          Pictures of bicycle parts such as wheels, dropper post, shocks, saddle, handlebar etc

The policy requiring a monthly payment is subject to a deductible during the first 3 months;

30% for the first month,

20% for the second month,

10% for the third month.
Date*

MonthDayYear
Date
E-mail address*

Confirmation Email
Phone Number*
The bicycle owner
Owner of bicycle*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Billing address

Same as aboveOther
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I want to use my bicycle shop

YesNo
The peferred bicycle shop
Bicycle shop
Contact person
Phone number shop
Email shop
Address

Street Address

Street Address Line 2

CityState

Zip Code

Components installed on the bicycle
Select component group*

ShimanoSRAMCampagnoloFSAOther
Shimano
Shimano component
SRAM
SRAM component
Campagnolo
Campagnolo component
FSA
FSA component
Other brands
Part(s)
Upload pictures of derailleurs, shifters, brakes and crankset*

Cancelof

Registration fee
Total value of items for coverage
Price for the premium/month
Price for 1 year
Price for premium/month:

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Price for 1 year premium

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Choose your coverage*

Price for premium/monthPrice 1 year
Grand Total
How did you hear about Bikeshield.com*

Internet researchBicycle shopSocial mediaWord of mouthMagazineOther
After submitting, administrator will review the form for approval.

This can take up to 24 hours. If approved you will recieve an email with a link that will provide the payment details.
Verify*
Should be Empty: