Southern Lights: A January Adventure in Progressive Christianity
Housing Registration Form • Epworth By The Sea
Friday, January 13, 2023 - Sunday, January 15, 2023
Address Line 2
** For Housing and Meals**
Rates are per person, based on the room occupancy
and include lodging for 2 nights, 6 meals, Georgia Motel Fee and tax.
Please check your choice:
Single Fri-Sun: $307.68
Double Fri-Sun: $207.32-EACH
Pitts / Booth
Single Fri-Sun: $337.92
Double Fri-Sun: $232.90-EACH
Single Fri-Sun: $363.50
Double Fri-Sun: $249.18-EACH
Single Fri-Sun: $386.76
Double Fri-Sun: $270.12-EACH
Number of Children (ages 3-12 years in room with adult): $52.32 per child
Number of Teens (ages 13-17 years in room with adult): $116.36 per child
Number of Adults:
How Many in Room?
My room is being paid for by:
Departure Date: Date:
Special Request (Diet, disability, etc):
Name(s) for Meal Ticket:
Roommate Name 1:
Roommate Name 2:
Roommate Name 3:
Full payment is due with individual reservation by December 1, 2022.
Event fills up quickly. Early Registration is advised.
Credit cards are charged upon reservation for the full amount.
Order Number from Southern Lights:
Submit Credit Card Information Below:
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:
How did you hear of this event?
Any individual cancellation after November 15, 2022 will forfeit the first night's charge per person.
Any cancellation after December 15, 2022 will forfeit the full charges per person.
Please submit this form online or you may print and 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 Tiffany Flavell:
firstname.lastname@example.org 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 FOR YOUR RECORDS BEFORE SUBMITTING ONLINE.