GMI - Global Ministries International
Epworth By The Sea • St. Simons Island, Georgia
Friday, May 3 - Saturday, May 4, 2024

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Arrival Date: +

Departure Date: Date: +

Roommate(s) Name:
Roommate other than family please complete separate form.

Number of 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 in each room, and include
1 night, 3 meals, tax, and state of Georgia motel fee.

PLEASE CHECK APPLICABLE RATES:

Pitts/Booth

Single: $170.26

Double: $119.65 per person

Triple: $98.87 per person

Quad: $92.58 per person

# of Children ages 3-12 in room with an adult(s): $28.65 per child

# of Teens ages 13-17 in room with an adult(s): $63.49 per teen

INDIVIDUAL FULL PAYMENT DUE WITH RESERVATION by April 19, 2024

Checks payable to Epworth By The Sea.

Check #:

Check Amount:

Or Submit Credit Card Information Below:
*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

Epworth Cancellation Policy:
Any individual cancellation after 30 days of arrival date will forfeit $50 per person.
Any individual cancellation after 14 days of arrival date will forfeit the first night's rate.
Any individual cancellation after 72 hours of arrival date will forfeit the entire per person charges.

Please submit this form online, or you may print & mail to:
Epworth By The Sea
Attn: Renthia Lewis
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
please email Renthia Lewis at rlewis@epworthbythesea.org or call 912-638-8688.

PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.

GMI - Global Ministries International Epworth By The Sea • St. Simons Island, GeorgiaFriday, May 3 - Saturday, May 4, 2024

Rates are per person based on the number of adults in each room, and include 1 night, 3 meals, tax, and state of Georgia motel fee.

INDIVIDUAL FULL PAYMENT DUE WITH RESERVATION by April 19, 2024

**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**

GMI - Global Ministries International
Epworth By The Sea • St. Simons Island, Georgia
Friday, May 3 - Saturday, May 4, 2024

Rates are per person based on the number of adults in each room, and include
1 night, 3 meals, tax, and state of Georgia motel fee.

PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.