JUST FOR ME
Housing Registration Form • Epworth By The Sea
Thursday, May 12, 2022 - Saturday, May 14, 2022
Address Line 2
Rates are per person based on the room occupancy
and include lodging for 2 nights, 6 meals,
Georgia Motel Fee and tax.
Please check your choice:
Double: $240.78 per person
Triple: $192.60 per person
Quad: $170.82 per person
Double: $219.84 per person
Triple: $176.32 per person
Quad: $163.84 per person
Double: $201.24 per person
Triple: $162.36 per person
Quad: $152.22 per person
How Many in Room?
My room is being paid for by:
Departure Date: Date:
Special Request (Diet, disability, etc):
Roommate Name 1:
Roommate Name 2:
Roommate Name 3:
$50 Deposit per person is due with individual reservation.
Credit cards are charged upon reservation for the deposit amount.
Submit Credit Card Information Below:
Name on Card
Credit Card Type
Amount To Charge:
Expiration Date (mm/yy)
3 Digit Security Code:
Billing Address Zip Code:
I am authorized to make these credit card charges:
How did you hear of this event?
Full refund prior to April 28, 2022.
Any cancellations after April 28, 2022 will forfeit $40.00 per person.
Any cancellations within 72 hours of arrival will forfeit full charges.
Please submit this form online or you may print and mail to:
Epworth By The Sea
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations, contact Trice Roberts:
firstname.lastname@example.org or 912-638-8688.
* CONFIRMATION OF YOUR RESERVATION WILL BE MAILED OR EMAILED 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.
PLEASE PRINT A COPY FOR YOUR RECORDS BEFORE SUBMITTING ONLINE.