Christ-St. Paul Church
Epworth By The Sea • St. Simons Island, Georgia
Friday, February 10, 2023 - Sunday, February 12, 2023
Address Line 2
Departure Date: Date:
Roommate other than family please complete separate form.
Roommate form MUST BE SUBMITTED ON THE SAME DAY as this form!
Check box if Roommate will pay separately:
Roommate pays separately
Number Adults in Room:
My room is being paid for by:
I am paying for how many people?:
Number of Children in Room:
(Ages 3-12 years)
Number of Teens in Room:
(Ages 13-17 years)
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:
Single Per Person: $365.42
Double Per Person: $251.10
Triple Per Person: $207.58
Quad Per Person: $195.10
Pitts / Booth
Single Per Person: $332.86
Double Per Person: $232.50
Triple Per Person: $193.62
Quad Per Person: $183.48
Single Per Person: $300.30
Double Per Person: $206.90
Triple Per Person: $175.02
Quad Per Person: $164.86
Child (Ages 3-12 years)
$56.78 per child
Teen (Ages 12-17 years)
$125.16 per teen
PLEASE INCLUDE TOTAL PAYMENT WITH RESERVATION
Make check payable to Epworth By The Sea
Or Submit Credit Card Information Below:
Online reservations must be paid for by credit card only.
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 Group Cancellation Policy:
Full payment due with reservation by Friday, January 27, 2023.
Any cancellation after Friday, January 27, 2023, will forfeit $40 per person.
Any cancellation within 72 hours of arrival will result in the forfeiture of the first night's charges per person.
Please submit this form online, or you may print & mail to:
Epworth By The Sea
Attn: Trice Roberts
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
please email Trice Roberts at
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**