EPWORTH BY THE SEA
Southeastern Writers Association Registration Form A SECURED PAGE FOR EPWORTH BY THE SEA
June 16 - 21, 2017 • Epworth By The Sea

Your Name
Address
City
State     Zip Code    
Phone       Email    
RATES ARE PER PERSON, BASED ON THE NUMBER OF ADULTS STAYING IN THE ROOM TOGETHER, AND INCLUDE LODGING FOR 5 NIGHTS, 14 MEALS, AND TAXES.
MEAL PLAN: FRIDAY SUPPER - WEDNESDAY BREAKFAST
RATES ARE PER PERSON:
  BUILDING
1 ADULT PER ROOM
2 ADULTS PER ROOM
  PITTS/BOOTH   $702.55   $479.70 - PER PERSON
  ROBERTSON INN       $755.95   $514.10 - PER PERSON
  TURNER LODGE       $813.30   $559.95 - PER PERSON
Arrival Date           Departure Date    
Special Request (Disability, etc.)  
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:
Make check payable to Epworth By The Sea.
Check #:   Amount: $
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
Deposit: FULL PAYMENT DUE WITH RESERVATION
Due: May 26, 2017.
ANY INDIVIDUAL CANCELLATION AFTER MAY 26, 2017 WILL RESULT IN A FORFEITURE OF FIRST NIGHT'S CHARGE. ANY INDIVIDUAL CANSCELLATION WITHIN 72 HOURS OF ARRIVAL WILL RESULT IN FORFEITURE OF THE FULL CHARGES PER PERSON.
Please submit this form online, or you may print & FAX to 912-634-0642, or mail to:
Epworth By The Sea
Attn: Tiffany Flavell
P. O. Box 20407
St. Simons Island, GA 31522
Email:tflavell@epworthbythesea.org
* CONFIRMATION OF YOUR RESERVATION WILL BE MAILED TO YOU *
No phone reservations accepted. No pets or alcohol. Check in: 4:00 p.m. - Check out 11:30 a.m. Sometimes great opportunities are missed when too many people wait until the last minute to register. We cancel undersubscribed events so please register early. We don't want to cancel what you want!!

This form is for Epworth By The Sea ONLY.