Winter Conference 2018 Housing Registration Form
January 28 - 31, 2018 • Sponsored by Epworth By The Sea
2.5 CEU Credit Available (Call 912-638-8688 for More Information)

Your Name
Address
City
State     Zip Code    
Phone       Email    
** Package Rates Are Per Person**
Lodging for 3 nights, 9 meals, state of Georgia motel fee, taxes, and programming fee
are included in the rates. Please check your choice:
  REYNOLDS PER PERSON SINGLE:   $365.61
  REYNOLDS PER PERSON DOUBLE:   $265.29
  PITTS/BOOTH PER PERSON SINGLE:   $396.60
  PITTS/BOOTH PER PERSON DOUBLE:   $285.90
  ROBERTSON INN PER PERSON SINGLE:   $431.01
  ROBERTSON INN PER PERSON DOUBLE:   $309.96
  TURNER LODGE PER PERSON SINGLE:   $461.94
  TURNER LODGE PER PERSON DOUBLE:   $340.96
  OFF CAMPUS FEE:
(Guests staying off campus, must pay the programing fee to attend the conference. This fee includes lunch at Epworth Monday, Tuesday and Wednesday.)
  $90.00
How many in room?   Adults (18+):
Children (3-12 yrs = $57.60 per child):   Teens (13-17 yrs = $132.36 per teen):
I am paying for how many people?
My room is being paid for by:
Arrival Date           Departure Date    
Special Request (Disability, etc.)  
Roommate Name  
Submit form with $50 per person deposit or full payment to: Epworth By The Sea.
Check #:   Amount: $
Charge to:   Visa      MasterCard     Discover    Amount to Charge: $
Card Number:        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
2.5 CEU Registration Form
I am registering for 2.5 CEU Credit  
Name 
Address 
City 
State      Zip Code    
Church 
Full refund for cancellations made by December 28, 2017.
Cancellations after December 28, 2017, forfeit $50.00 per person.
Please submit this form online, or you may print & FAX to 912-634-0642, or mail to:
Epworth By The Sea
Attn: Kelly Maloy
P. O. Box 20407
St. Simons Island, GA 31522
Email:kmaloy@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.