subject_line
Clergy Spouses Retreat 2024
Epworth By The Sea • St. Simons Island, Georgia
Friday, March 15 - Sunday, March 17, 2024
First Name
*
Last Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
Arrival Date:
+
Departure Date: Date:
+
Roommate Request:
(Roommates other than family, complete separate form.)
Number 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 STAYING IN THE ROOM TOGETHER,
AND INCLUDE LODGING FOR 2 NIGHTS, 6 MEALS (FRIDAY SUPPER-SUNDAY LUNCH), GA MOTEL FEE AND TAX.
PLEASE CHECK APPLICABLE RATES:
Turner Lodge
Single (1 adult per room): $392.16
Double (2 adults per room): $265.12 per person
Triple (3 adults per room): $214.16 per person
Quad (4 adults per room): $192.20 per person
Robertson Inn
Single (1 adult per room): $359.30
Double (2 adults per room): $239.30 per person
Triple (3 adults per room): $200.08 per person
Quad (4 adults per room): $185.16 per person
Pitts / Booth
Single (1 adult per room): $324.10
Double (2 adults per room): $220.52 per person
Triple (3 adults per room): $183.66 per person
Quad (4 adults per room): $168.74 per person
FULL PAYMENT DUE WITH INDIVIDUAL RESERVATION BY FEBRUARY 16, 2024
Make check payable to Epworth By The Sea
Check #:
Check Amount:
Or Submit Credit Card Information Below:
Online reservations must be paid for by credit card only.
There is a 3% Credit Card Transaction Fee on payments over $1,000.
Name on Card
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
How did you hear about this event?
*
Epworth Cancellation Policy:
Any individual cancellation prior to 30 days of the group's arrival date will receive a full refund.
Any individual cancellation within 30 days of the group's arrival date will forfeit the first night's charge per person.
Any individual cancellation within 2 weeks of the group's arrival date 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,
please email
tflavell@epworthbythesea.org
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**