Miller’s Grant Mission Miles: Sponsor and Walker Registration Form

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- Miller’s Grant Mission Miles
Sales and Marketing:
410-465-2005
General Business:
410-696-6700

Sales and Marketing: 410-465-2005
General Business: 410-696-6700

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Families walking along the Miller's Grant Mission Miles walk route.

Lutheran Village at Miller's Grant
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Miller’s Grant Mission Miles: Sponsor Registration Form

Complete the Sponsor Registration form with the following information.

Sponsor Registration

Contact Name(Required)

First Last

Company Name

Company Name as You Wish it to Appear in Advertising

Email(Required)

Phone(Required)

Billing Address (Address where credit card statement is sent.)(Required)

Street Address City State ZIP Code

Sponsorship Level

50/50 Raffle Tickets

Purchase one raffle ticket for $10 or up to 24 tickets for $200. You do not need to be present to win.

I am unable to sponsor Miller's Grant's Mission Miles but want to help seniors in need. Please accept my tax-deductible gift.

Enter an amount in the box below.

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Walker Registration

Walkers must be register. There is no cost to walk the event.

Walker 1: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 2: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 3: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 4: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 5: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 6: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 7: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

Do you want to register another walker?

Yes

No

Walker 8: First Name

First

Last Name

Last

Age

T-shirt Size

Available for ages 10+. T-shirts are only available in adult sizes.

Phone

Email

Does this person live in the same household as walker 1?

Yes

No

Home Address

Street Address City State ZIP Code

For more information, contact Karen McNamara at 410-696-6774 or kmcnamara@lsmmd.org.

Sponsor and walker contact information will not be sold or shared with third-party vendors.

Area Attractions:

A. Patapsco Valley State Park:
4.4 miles

B. Centennial Park:
4.4 miles

C. Historic Ellicott City:
2.6 miles

D. Howard County Conservancy:
4.5 miles

E. Turf Valley Resort:
3.8 miles

F. Long Gate Shopping Center:
3.1 miles

G. Fairway Hills Golf Course:
3.7 miles

H. Enchanted Forest Shopping Center:
1.9 miles

I. Chatham Station Shopping
Center: 1.7 miles

J. St. John’s Shopping Center:
1.7 miles

K. Columbia Mall:
5.7 miles

Lutheran Village at Miller’s Grant
A Lutheran Social Ministries of Maryland Community
9000 Fathers Legacy
Ellicott City, MD 21042

Sales and Marketing: 410-465-2005
General Business: 410-696-6700

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