Springtime By The Sea
"Senior Adult Vacation Bible School with Ed Kilbourne"

An Event for Older Adults
May 22 - 25, 2017
Lodging Reservation Form • Epworth By The Sea

Registration begins Monday at 4:00pm.
The event begins with dinner Monday 5:30-7:00pm and concludes with Thursday morning breakfast.

Your Name     Male   Female
Address
City
State     Zip Code    
Phone       Email    
Roommate Request:
Roommates other than family, complete separate form.
Number of Adults in room:     I am paying for how many people?
My room is being paid for by:
Indicate Group Name if you are part of a group (Please mail all forms together):
Registration includes: 3 nights' lodgingin Pitts Booth motel;
8 meals; all scheduled activities; registration fee and taxes.
View accommodations online.
Please check applicable rate:
PITTS/BOOTH:
  $471.60 per adult
1 adult per room
  $360.90 per adult
2 adults per room
  $327.42 per adult
3 adults per room
  $319.29 per adult
4 adults per room
TOTAL:   $
Special Request       (Disability, diet, etc.)
Arrival Date Departure Date
PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATIONS.
Make check payable to Epworth By The Sea.
Check #    Amount: $   
OR
Charge to:    Visa        MasterCard        Discover    Amount to Charge: $
Card Number:        Expiration Date:
Name on Card:       
 Check here to affirm that I am authorized to make these credit card charges
Epworth Cancellation Policy:
Full refund prior to April 22, 2017. Cancellations 1 month prior to event forfeit registration fee.
Cancellations within 2 weeks of event forfeit registration fee and first night's lodging and meals.
Please submit this form online, print & FAX to 912-634-0642, or mail to:
Epworth By The Sea
ATTN: Renthia Lewis
P. O. Box 20407
St. Simons Island, GA 31522
Email: rlewis@epworthbythesea.org
No phone reservations accepted. No pets or alcohol. Check in: 4:00 p.m. - Check out 11:30 a.m.
* CONFIRMATION OF YOUR RESERVATION WILL BE EMAILED OR MAILED TO YOU *
This form is for Epworth By The Sea ONLY.