2nd Providence Baptist Church
Epworth By The Sea • St. Simons Island, Georgia
Friday, February 23 - Sunday, February 25, 2024
Address Line 2
Departure Date: Date:
Roommate other than family please complete separate form.
Roommate form MUST BE SUBMITTED ON THE SAME DAY as this form!
Number Adults in Room:
Number Children (ages 3-12) in Room:
Number Teens (ages 13-17) in Room:
I am paying for how many people?:
My room is being paid for by:
Special Request (Diet, disability, etc.):
Rates are per person based on the number of adults in each room and include 2 nights, meals, tax and state of Georgia motel fee.
PLEASE CHECK APPLICABLE RATES:
Single Occupancy: $340.52
Double Occupancy: $239.30 per person
PLEASE INCLUDE $50.00 DEPOSIT PER PERSON WITH YOUR RESERVATION.
Checks payable to Epworth By The Sea.
Or Submit Credit Card Information Below.<BR>
There is a 3% Credit Card Transaction Fee on payments over $1,000.
ACCEPT AMERICAN EXPRESS CREDIT CARDS.**
Name on Card
Amount To Charge:
Expiration Date (mm/yy)
3 Digit Security Code:
Billing Address Zip Code:
I am authorized to make these credit card charges:
Epworth Cancellation Policy:
Remaining balance is due upon check-in.
Any individual cancellation after January 23,2024, will result in a forfeiture of $50 per person.
Any individual cancellation within 72 hours of arrival will forfeit first night's charges.
Please submit this form online, or you may print & mail to:
Epworth By The Sea
Attn: Erica Bautista
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
please email Erica Bautista at
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**