IDEAS Conference
MEALS OPTION ONLY
June 4 - 8, 2018 • Epworth By The Sea
Your Name
Address
City
State     Zip Code    
Phone       Email    
Please check all meals you plan on eating at Epworth By The Sea,
then enter the total based on the following rates:
Breakfast - $9.27 + tax = $9.92
Lunch - $12.36 + tax = $13.23
Supper - $14.42 + tax = $15.43
Monday Supper
Tuesday Breakfast
Tuesday Lunch
Tuesday Supper
Wednesday Breakfast
Wednesday Lunch
Wednesday Supper
  Thursday Breakfast
Thursday Lunch
Thursday Supper
Friday Breakfast
Friday Lunch

Total: $
PLEASE INCLUDE FULL PAYMENT WITH REGISTRATION.
Make check payable to Epworth By The Sea.
Check #    Amount $   
OR
Charge to:   Visa        MasterCard        Discover      Amount to Charge: $
Card Number:     Expiration Date:    CVV Code:
Name on Card:    Zip Code of Billing Address:
 Check here to affirm that I am authorized to make these credit card charges
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.
**ALL ROOMS ARE NON-SMOKING. RESERVATIONS NOT ACCEPTED BY PHONE BUT MAY BE MAILED, FAXED, OR EMAILED TO THE INFORMATION BELOW
Epworth By The Sea
P. O. Box 20407
St. Simons Island, GA 31522
Please email any questions to kmaloy@epworthbythesea.org.
No pets or alcohol. Check in: 4:00 p.m. - Check out 11:30 a.m.
* CONFIRMATION OF YOUR RESERVATION WILL BE MAILED OR EMAILED TO YOU *
This form is for Epworth By The Sea ONLY.
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: