Hinesville Alumnae Chapter of Delta Sigma Theta
Housing Registration Form
Friday, August 18, 2023 - Sunday, August 20, 2023
Epworth By The Sea • St. Simons Island, Georgia

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Rates listed below are per person based on the number of adults staying in the room together, and include lodging, meals, state of Georgia motel fee and taxes.
PLEASE SELECT FROM THE FOLLOWING ACCOMMODATIONS:

Turner Lodge
Lodging for 2 nights and 5 meals
Friday Supper - Sunday Breakfast

Single (1 adult per room): $399.20

Double (2 adults per room): $281.54 per person

Triple (3 adults per room): $228.24 per person

Quad (4 adults per room): $208.64 per person

Turner Lodge
Lodging for 1 night and 3 meals
Friday Supper - Saturday Lunch

Single (1 adult per room): $199.60

Double (2 adults per room): $140.77 per person

Triple (3 adults per room): $114.12 per person

Quad (4 adults per room): $104.32 per person

Roommate Name:

Number Adults in Room:

I am paying for how many adults?

My room is being paid for by: *

Arrival Date: +

Departure Date: Date: +

Special Request (Diet, disability, etc):

HOTEL RESERVATIONS:
Full payment due with individual reservation by July 18, 2023.
PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATION
Make check payable to Epworth By The Sea

Check #:

Check Amount:

Or Submit Credit Card Information Below:
There is a 3% Credit Card Transaction Fee on payments over $1,000.

Name on Card

Credit Card Type:

Visa

MasterCard

Discover

Amount To Charge:

CARD NUMBER:

Expiration Date (mm/yy)

3 Digit Security Code:

Billing Address Zip Code:

Authorization:

I am authorized to make these credit card charges:

Today's Date +

Authorized Signature

clear

EPWORTH CANCELLATION POLICY:
Any individual cancellation after August 4, 2023 will forfeit one night's lodging per person.
Any individual cancellation after August 11, 2023 will forfeit the full charges per person.

Please submit this form online or you may print and mail to:
Epworth By The Sea
Attn: Tiffany Flavell
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
contact Tiffany Flavell: tflavell@epworthbythesea.org or call 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 OF THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.

Hinesville Alumnae Chapter of Delta Sigma Theta Housing Registration Form Friday, August 18, 2023 - Sunday, August 20, 2023Epworth By The Sea • St. Simons Island, Georgia

Rates listed below are per person based on the number of adults staying in the room together, and include lodging, meals, state of Georgia motel fee and taxes. PLEASE SELECT FROM THE FOLLOWING ACCOMMODATIONS:

HOTEL RESERVATIONS:Full payment due with individual reservation by July 18, 2023.PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATIONMake check payable to Epworth By The Sea

Or Submit Credit Card Information Below: There is a 3% Credit Card Transaction Fee on payments over $1,000.