= Required Fields

Online Form - Vincent Scooter Safe Lock Form

Have you been a previous recipient of the Vincent Scooter Safe Locks?
Are you a City of Vincent resident?
I understand that the City of Vincent accepts NO liability of harm or damage to the recipient/user or property in the use of the Vincent Scooter Safe lock. Responsibility for theft of scooter, damage, repair or harm to person or property in the use or storage of the Vincent Scooter Safe Lock is the responsibility of the user.