COMMUTERS
Southern Lights: A January Adventure in Progressive Christianity
Epworth By The Sea
Friday, January 17, 2025 - Sunday, January 19, 2025

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Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Name(s) for meal ticket: *

Commuter Fee: $120.00 per person

Includes: Friday Supper, Saturday Lunch & Supper, Sunday Lunch and Grounds Fee

Arrival Date: +

Departure Date: Date: +

Special Request (Diet, disability, etc):

Full payment is due with individual reservation.
Credit cards are charged upon reservation for the full amount.

Southern Lights Order Number: *

Check #:

Check Amount:

**WE DO NOT ACCEPT AMERICAN EXPRESS CREDIT CARDS.**

Name on Card

Card Type

CARD NUMBER:

Amount To Charge:

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3 Digit Security Code:

Billing Address Zip Code:

Authorization:

I am authorized to make these credit card charges:

Today's Date: +

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