| Your Name ||
| Name(s) for nametags: || |
|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' lodging in Pitts/Booth motel, 8 meals,|
registration fee, tax and Georgia State Motel Fee.
View accommodations and detailed agenda online at www.epworthbythesea.org.
Please check applicable rate:
| PITTS/BOOTH: |
| $350.90 per adult staying 2 adults per room
| $461.60 per adult staying 1 adult per room TOTAL: $
| ROBERTSON INN (Limited Availability): |
| $374.96 per adult staying 2 adults per room
| $496.01 per adult staying 1 adult per room TOTAL: $
|Special Request (Disability, diet, etc.) |
Departure Date |
|PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATIONS. |
Make check payable to Epworth By The Sea. |
Check # Amount: $
Discover Amount to Charge: $
Expiration Date: |
3 Digit Security Code:
Zip Code of Billing Address:
|Name on Card:
| Check here to affirm that I am authorized to make these credit card charges
|Epworth Cancellation Policy:
Full refund prior to September 18, 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: Tiffany Benson
P. O. Box 20407
St. Simons Island, GA 31522
|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 SENT TO YOU *
This form is for Epworth By The Sea ONLY.