Lady Bug Retreat
Epworth By The Sea • St. Simons Island, Georgia
Friday, November 10 - Sunday, November 12, 2023
Address Line 2
Departure Date: Date:
Roommate other than family please complete separate form.
Number of Adults in Room:
My room is being paid for by:
I am paying for how many people?:
Special Request (Diet, disability, etc.):
Rates are per person based on the number of adults in each room, and include
2 nights, 6 meals, tax, and state of Georgia motel fee.
PLEASE CHECK APPLICABLE RATES:
Double: $265.52 per person
Triple: $216.90 per person
Quad: $194.94 per person
Double: $244.38 per person
Triple: $200.48 per person
Quad: $187.90 per person
Double: $225.62 per person
Triple: $186.40 per person
Quad: $176.16 per person
INDIVIDUAL FULL PAYMENT DUE WITH RESERVATION OCTOBER 10, 2023
Checks 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.
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:
Any individual cancellation after October 28, 2023 will result in a forfeiture of $50.00 per person.
Any individual cancellation within 72 hours of arrival will result in a forfeiture of entire per person charge.
Please submit this form online, or you may print & mail to:
Epworth By The Sea
Attn: Renthia Lewis
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
please email Renthia Lewis at
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**