Monday, October 12, 2020-Thursday, October 15, 2020
Address Line 2
(Roommates other than family, complete separate form.)
Indicate Group Name if you are part of a group.
(Please mail all forms together.)
Registration includes: 3 nights' lodging in Pitts/Booth motel;
8 meals; all scheduled activities, registration fee and taxes.
View accommodations online at
Please check applicable rate:
$484.78 per adult staying 2 adults per room
$627.07 per adult staying 1 adult per room
TOTAL AMOUNT DUE FOR ROOMS:
(Disability, Diet, etc.)
Number of Nights
PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATIONS
Make check payable to Epworth By The Sea.
Or Submit Credit Card Information Below:
CREDIT CARD TYPE
AMOUNT TO CHARGE:
NAME ON CARD
NOTE: IF PAYING BY CHECK PLEASE PUT "N/A" IN THIS SPACE!
Expiration Date (mm/yy)
3 DIGIT SECURITY NUMBER
BILLING ADDRESS ZIP CODE:
I am authorized to make these credit card charges:
I Am Authorized
EPWORTH CANCELLATION POLICY:
• FULL REFUND PRIOR TO SEPTEMBER 12, 2020
• CANCELLATIONS 1 MONTH PRIOR TO EVENT FORFEIT $220 REGISTRATION FEE.
• CANCELLATIONS WITHIN 2 WEEKS OF EVENT WILL FORFEIT REGISTRATION FEE,
FIRST NIGHT'S LODGING AND MEALS FEE.
Please submit this form online, or you may print & FAX to 912-634-0642, or mail to:
Epworth By The Sea
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations, contact June Davis:
email@example.com or 912-638-4614
* 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.
This form is for Epworth By The Sea ONLY.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**