True Life Ministries
Housing Registration Form • Epworth By The Sea
Thursday, June 15, 2023 - Monday, June 19, 2023

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Rates are per person, based on the number of adults staying in the room together,
and include lodging for 4 nights, 12 meals, Georgia Motel Fee, and tax.
Please check your choice:

Pitts / Booth

Single: $671.68 per person staying 1 adult per room

Double: $469.20 per person staying 2 adults per room

Triple: $390.80 per person staying 3 adults per room

Quad: $370.32 per person staying 4 adults per room

Child or Teen (In room with an adult) *

Child (ages 3-12 years): $114.60 per child

Teen (ages 13-17 years): $253.96 per teen

How Many Children in Room?
(ages 3-12 years)

How Many Teens in Room?
(ages 13-17 years)

How Many Adults in Room?

How Many Total in Room?

My room is being paid for by: *

Arrival Date: +

Departure Date: Date: +

Special Request (Diet, disability, etc):

Full payment is due with individual reservation by May 24, 2023.
Credit cards are charged upon reservation for the full amount.

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

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: +

Signature:

clear

Cancellation Policy:
Any individual cancellation within 30 days of arrival will forfeit $50.00 per person.
Any individual cancellation within 14 days of arrival will forfeit first night's rate.
Any individual cancellation within 72 hours of arrival will forfeit entire per person charges.

Please submit this form online or you may print and mail to:
Epworth By The Sea
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 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 FOR YOUR RECORDS BEFORE SUBMITTING ONLINE.

True Life Ministries Housing Registration Form • Epworth By The Sea Thursday, June 15, 2023 - Monday, June 19, 2023

Rates are per person, based on the number of adults staying in the room together, and include lodging for 4 nights, 12 meals, Georgia Motel Fee, and tax. Please check your choice:

Full payment is due with individual reservation by May 24, 2023.Credit cards are charged upon reservation for the full amount.