Women in Recovery Retreat By The Sea
Epworth By The Sea • St. Simons Island, Georgia
Friday, May 3, 2024 - Sunday, May 5, 2024

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Arrival Date: +

Departure Date: Date: +

Number Adults in Room: *

My room is being paid for by: *

I am paying for how many people?: *

Special Request (Diet, disability, etc):

Roommate Request: (Roommates other than family, complete separate form.)

Rates are per person based on the number of adults in each room, and include
2 nights, meals, tax and state of Georgia motel fee.

PLEASE CHECK APPLICABLE RATES:

Pitts/Booth Motel

Single Occupancy: $354.60

Double Occupancy: $248.68 per person

Early night arrival or stayover - No meals included:

Pitts/Booth Motel

Room rate per night in Pitts/Booth: $157.56

PLEASE INCLUDE $100.00 DEPOSIT PER PERSON WITH YOUR RESERVATION.
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.

**WE DO NOT ACCEPT AMERICAN EXPRESS CREDIT CARDS.**

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

Epworth Cancellation Policy:
Any individual cancellation after April 19, 2024, will result in a forfeiture of $50 per person.
Any individual cancellation within 72 hours of arrival will forfeit first night's charges.

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 troberts@epworthbythesea.org or call 912-638-8688.

PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.

Women in Recovery Retreat By The Sea Epworth By The Sea • St. Simons Island, GeorgiaFriday, May 3, 2024 - Sunday, May 5, 2024

Rates are per person based on the number of adults in each room, and include 2 nights, meals, tax and state of Georgia motel fee.

Early night arrival or stayover - No meals included:

PLEASE INCLUDE $100.00 DEPOSIT PER PERSON WITH YOUR 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.