GEORGIA ADDICTION COUNSELORS ASSOCIATION
Epworth By The Sea Housing Registration Form
Friday, October 20 – Monday, October 23, 2023
Address Line 2
** Package rates are per person, based on the number of adults staying in the room together, and include lodging for 3 nights, 9 regular dining room meals, meeting room appropriate for the size of the group as determined by Epworth, and taxes. Rates are subject to change based on any change to taxes. **
**Additional, non-conference guests pay the same per person rate for lodging and meals. All occupants of the room must be noted.**
***Most rooms have two queen sized beds. Triples and Quads have to share beds***
1 Adult Per Room: $598.80
2 Adults Per Room: $422.31 per person
3 Adults Per Room: $342.36 per person
4 Adults Per Room: $312.96 per person
1 Adult Per Room: $563.58
2 Adults Per Room: $390.63 per person
3 Adults Per Room: $317.73 per person
4 Adults Per Room: $295.35 per person
1 Adult Per Room: $524.88
2 Adults Per Room: $366.00 per person
3 Adults Per Room: $300.12 per person
4 Adults Per Room: $281.28 per person
Number of Children (ages 3-12) in Room with Adult:
$85.95 per child
Number of Teens (ages 13-17) in Room with Adult:
$190.47 per teen
My room is being paid for by:
Departure Date: Date:
Special Request (Diet, disability, etc):
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:
Any individual cancellation within 30 days of arrival date will forfeit your per person deposit.
Any individual cancellation within 14 days of arrival date will forfeit the first night’s rate.
Any individual cancellation within 72 hours of arrival date will forfeit the entire per person charges.
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 by reservation form.
For any additional information regarding accommodations, contact Tiffany Flavell:
email@example.com 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 OF THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.*