IDEAS Conference Participant Registration Form

June 4 - 8, 2018 • Epworth By The Sea
Section 1: IDEAS Attendee Information
  Last Name:   First Name:
  Address:
  City:   State:     Zip Code:
  Phone:   Cell:
  Email:   Alternate Email:
  Agency or District:
  Arrival Date:   Departure Date:
Roommates Attending IDEAS: Each person attending IDEAS in room MUST complete a separate form/roommate.
    Last Name:     First Name:
    Last Name:     First Name:
    Last Name:     First Name:
    Family Members: Complete Section 3 and provide personal
Section 2: Select Building
Room: Room rates are calculated per night see Table 1. Exemption Forms required with payment. Forms will not be accepted after checkin. Purchase Orders will be accepted, but must be paid by May 15, 2018. Reservations for each motel are on a first come first serve basis, based on availability.
MEAL PLANS: A Meal plan is required for all guests staying at Epworth. See Table 2.
Building
Building
  Turner Lodge
  Pitts/Booth
  Robertson Inn / ReynoldsApts.
  Reynolds
  Wheelchair Accessible Room (in requested building)
Special Requests:
Section 3: Conference Attendee Cost Calculations:
$
  1) Building Selection Rate (Include Correct Exemption Rate and Provide Exempt Forms with Payment)
  2) Number of Nights
  3) Subtotal (Multiply Line 1 X Line 2) $
  Rate      # Nights   # People
  4) Adult Meal Plan (Number of Conference Attendees in Room) X   X  = $
  5) Total (Add Line 3 and Line 4) $
Section 4: Payment Information For use only for school transactions
  Check Number (Make checks payable to Epworth By The Sea):    
  Purchase Order Number (For all purchases including cards):   
  Credit Card Number:      Exp. Date:    CVV Code:
  Name on Card:   
  Billing Address:    City: State: Zipcode:
  MasterCard     Visa     Discover
  Authorized Cardholder Name:
  By checking this box, i certify that I am authorized to make these charges on this card
Section 5: Family/Guest Information: Use this section only for Epworth Guests not attending conference and paid from a personal account.
Meal Plans
Rate (Non-Exempt)
# Persons
$
  1) Adult Meal Plan (Ages 13 & Up) $38.57
= $
  2) Youth Meal Plan (Ages 3-12) *No charge for children under 3 yrs* $19.30
= $
  Total Add (Line 1 + Line 2)    $
Family/Guest Payment Information: For use only for personal transactions
  Check Number (Make checks payable to Epworth By The Sea):    
  Credit Card Number:      Exp. Date:    CVV Code:
  Name on Card:   
  Zip Code of Billing Address:   
  MasterCard     Visa     Discover
Section 6: Reservation Form Submission
  Reserve lodging online: www.epworthbythesea.org/events/
  Contact Information:
  Epworth By The Sea
  P. O. Box 20407
  St. Simons Island, GA 31522
  FAX: (912) 634-0642
  Email: kmaloy@epworthbythesea.org

Lodging Form Instructions
Section 1: IDEAS Attendee Information
Fill out contact information for conference attendee.

Roommates: List names of additional conference attendees sharing room with you. Each conference attendee must complete a separate lodging form.


Section 2: Room Selection and Rates
Reservations for each motel are on a first come first serve basis.

Rates are calculated on a per night basis [rate x night(s)] and include GA Hotel/Motel Tax (non-exempt). Meal plans are NOT optional if staying at Epworth. Costs are calculated on a daily rate and include dinner on the date of arrival and lunch on the date of departure. * Wheelchair accessibility Turner King bed with pullout. Pitt's/Booth 2 Twins or 1 King.

Table 1 - Facility
Total/Night
Bed Tax Exempt/Night
Bed and Sales Tax
Exempt/Night***
  *Turner Lodge
$150.16
$143.86
$135.04
  Robertson Inn / Reynolds Apartments
$131.73
$126.23
$118.53
  *Pitts / Booth
$ 117.91
$ 113.01
$ 106.15
Table 2 - Meal Plan
Total/Night
 
Sales Tax Exempt/Night***
  Adult
$38.57
N/A
$36.05
  Youth
$19.30
N/A
N/A

Section 3: Conference Attendee Cost Calculations
Enter room rate based on selections in Section 2 and supporting Table 1.

Multiply the Rate times the number of nights and enter the subtotal (split in half).

Enter the number of Meal Plans (1 required for each person staying in a room) Table 2. Multiply by the number of nights staying and enter the totals

Add the room subtotal and the meal plan total then Enter Total Cost. for conference attendee only

** Local Bed tax exemption. You must submit signed Bed Tax Exemption form (see your district procedures).

*** Payment must be made using school check or credit card and you must submit both a signed Bed Tax and State Tax (Sales) Exemption form (see your district procedures) to qualify for both state tax and local bed tax exemption. NOTE: Georgia requires a purchase order for all state-funded credit cards (state, local school districts, universities) and that are receiving state tax exemption.

Note: These rates also include a $5.00/night non-exempt State Hotel Room Fee.


Section 4: Payment Information (only for school payments)
Full payment required: Make checks payable to Epworth by the Sea (preferred payment method) or charge to MasterCard/VISA/Discover. Charges will be run upon receipt of lodging reservation form

Full payment is required at time of booking and credit card charges are run upon receipt of lodging reservation

Purchase Orders will be accepted, but must be paid by May 9, 2018

This section is used to calculate cost only if conference attendee's lodging is paid for on a school account. Use section 5 if attendee is paying for lodging on a personal account (regardless if the fee is reimbursed).


Section 5: Family and Guest Information (Those staying at Epworth but not attending IDEAS
Enter the number of Meal Plans (1 required for each person staying in a room) Table 2. Multiply by the number of nights staying and enter the total.

Section 6:
Register at www.epworthbythesea.org/events/ or submit form to Epworth by the Sea by email, mail. or fax.
No telephone reservations.

Epworth By The Sea
P. O. Box 20407
St. Simons Island, GA 31522
FAX: (912) 634-0642

Full payment no later than May 15, 2018

Additional Information
Check-in 4 PM / Check-out 11:30 AM

Cancellation Policy: Full refund on or before May 15, 2018, after May 15 first night's rate is not refunded.
Any cancellations made after June 1, 2018 will forfeit entire rate. Any date changes made to reservations after June 1, 2018 will not be refunded.

Lodging Questions: Contact Epworth by the Sea. Phone: 912-638-8688 or kmaloy@epworthbythesea.org

Confirmations will be issued by Epworth by the Sea within 72 hours.
PURCHASE ORDER CREDIT CARD AUTHORIZATION FORM
  Guest Name:
  Group Name:
*Credit Cards must be issued by the State of Georgia. State issued credit cards are tax exempt. Sales tax and hotel/motel tax exemption forms must accompany this form. Associations, booster clubs and personal methods of payments are not tax exempt.
CREDIT CARDHOLDER INFORMATION:
NAME ON CREDIT CARD:  
TYPE OF CREDIT CARD:   Visa     Mastercard     Discover
COMPANY NAME:  
ACCOUNT NUMBER:  
EXPIRATION DATE:  
BILLING ADDRESS:  
CITY:       STATE:     ZIPCODE:
PHONE:       FAX:
AUTHORIZED USER OF CREDIT CARD:
NAME:  
COMPANY:  
PHONE NUMBER:  
EMAIL ADDRESS:  
IDENTIFICATION:  
RELATION TO OWNER:  
TYPE OF CHARGES:  
AUTHORIZED AMOUNT:   $
DATES OF CHARGES:  
AUTHORIZATION OF CARD USE:
    I certify that I am the authorized holder and signer of the credit card referenced above.
    I certify that all information above is complete and accurate.
    I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the "AUTHORIZED AMOUNT" field. I understand this is only for up to this amount during the time period of "DATES OF CHARGES" referenced above. If additional charges are going to be authorized a new form will have to be completed.
CARDHOLDER NAME:  
DATE: