Living Life to the Fullest: An Older Adult Retreat
Monday, May 16, 2022-Thursday, May 19, 2022
Epworth By The Sea Housing Form

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Name(s) for Nametag: *

ROOM RATES ARE PER PERSON,
based on the number of adults staying in the room together,
and include lodging for 3 nights, 8 meals, registration fee and taxes.
View accommodations at www.EpworthByTheSea.org:
Please check applicable rate:

Pitts/Booth

Single Occupancy: $467.98 per person staying 1 adult per room

Double Occupancy: $313.93 per person staying 2 adults per room

Robertson Inn

Single Occupancy: $502.87 per person staying 1 adult per room

Double Occupancy: $341.86 per person staying 2 adults per room

Turner Lodge

Single Occupancy: $551.71 per person staying 1 adult per room

Double Occupancy: $380.23 per person staying 2 adults per room

*Sign ups for the Dolphin Tour, Moore Methodist Museum Tour, Trolley Tour and AIM Exercise Class will be at check-in. There is limited seating for the Shrimp Boat Excursion on Wednesday afternoon. Please indicate below if you are interested and the number of people attending. Reservations taken on a first come, first serve basis. Thank you!

Shrimp Boat Excursion (Wednesday Only)

Number Attending Shrimp Boat Excursion:

Roommate Request:
We request roommates complete separate forms, and mail form in together (couples may send in one form).

Arrival Date: +

Departure Date: Date: +

Number of Adults in Room: *

I am paying for how many people? *

My room is being paid for by: *

Special Request (Diet, disability, etc):

Submit form with full payment to: Epworth By The Sea.

Check #:

Check Amount:

Or Submit Credit Card Information Below:
The full amount will be charged upon reservation.

Name on Card

Card Type

CARD NUMBER:

Amount To Charge:

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 April 15, 2022 will forfeit $100 per person.
Any individual cancellation after April 29, 2022 will forfeit the first night's charge per person.
*Any individual cancellation after May 6, 2022 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.
Email Questions to Tiffany Flavell: tflavell@epworthbythesea.org

* CONFIRMATION OF YOUR RESERVATION WILL BE EMAILED OR MAILED 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.

Living Life to the Fullest: An Older Adult Retreat Monday, May 16, 2022-Thursday, May 19, 2022Epworth By The Sea Housing Form

ROOM RATES ARE PER PERSON, based on the number of adults staying in the room together, and include lodging for 3 nights, 8 meals, registration fee and taxes. View accommodations at www.EpworthByTheSea.org:Please check applicable rate:

Submit form with full payment to: Epworth By The Sea.

Or Submit Credit Card Information Below: **The full amount will be charged upon reservation.**

EPWORTH CANCELLATION POLICY:*Any individual cancellation after April 15, 2022 will forfeit $100 per person. *Any individual cancellation after April 29, 2022 will forfeit the first night's charge per person. *Any individual cancellation after May 6, 2022 will forfeit the full charges per person.