Lady Bug Retreat
Epworth By The Sea • St. Simons Island, Georgia
Friday, November 8 - Sunday, November 10, 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
2 nights, 6 meals, tax, and state of Georgia motel fee.

PLEASE CHECK APPLICABLE RATES:

Turner Lodge

Single: $406.24

Double: $279.20 per person

Triple: $228.24 per person

Quad: $203.94 per person

Robertson Inn

Single: $385.12

Double: $258.08 per person

Triple: $211.82 per person

Quad: $196.90 per person

FULL PAYMENT DUE WITH RESERVATION BEFORE OCTOBER 10, 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.

**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 within 30 days of arrival date will forfeit your per person deposit.
• Any individual cancellation within 14 days of arrival date will forfeit the first night’s rate.
• Any individual cancellation within 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.

Lady Bug Retreat Epworth By The Sea • St. Simons Island, GeorgiaFriday, November 8 - Sunday, November 10, 2024

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.

FULL PAYMENT DUE WITH RESERVATION BEFORE OCTOBER 10, 2024.

Or Submit Credit Card Information Below: There is a 3% Credit Card Transaction Fee on payments over $1,000.

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

Lady Bug Retreat
Epworth By The Sea • St. Simons Island, Georgia
Friday, November 8 - Sunday, November 10, 2024

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.

Or Submit Credit Card Information Below:
There is a 3% Credit Card Transaction Fee on payments over $1,000.

PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.