Select which event you're registering for: *


 
Full Name *

 
Address

 
Street *

 
Suite/Apartment #

 
City *

 
Zip Code *

 
Phone Number *

 
Date of Birth *

 
Gender *


 
Shirt Size *


 
Emergency Contact Information

 
Full Name *

 
Phone Number *

 
Liability and Race Agreement: *

In consideration of your acceptance of this ride entry, I, for myself, my heirs, executors, administrators and assigns, forever release and discharge any and all rights, demands, claims for damages and causes for suit or action, known or unknown, that I may have against the Miles4Milla Ride, the Kemmons Wilson Family Center for Good Grief, Baptist Memorial Health Care and its affiliates and subsidiaries, the city, volunteers, and any and all participating ride sponsors, organizers, and any other organizations associated with this event, and the directors, officers, employees and agents of such parties, for any and all injuries in any manner arising or resulting from my participation manner in said ride. I attest and verify that I have full knowledge of the risks involved in the ride, that I assume these risks, that I will assume and pay my own medical and emergency expenses in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses, and that I am physically fit and sufficiently trained to participate in this ride. I release the rights to any and all photographic material and computer information Miles4Milla may wish to release for this event without obligation to me.
     
 
Registration Fee *

Registration fee is per individual, whether you ride/run or not. Price covers your registration fee, a free t-shirt, your 1st beer and food.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


Thank you for helping us raise funds and awareness for the newest location of the Kemmons Wilson Family Center for Good Grief, Milla's House.

If you would like to make an additional donation, please click "Donate" from the main site.