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WOMEN OF SION
Epworth By The Sea • St. Simons Island, Georgia
Thursday, February 6 - Sunday, February 9, 2025
First Name
*
Last Name
*
Street Address
*
Address Line 2
City
*
State
*
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Zip Code
*
Phone Number
*
Email Address
*
Arrival Date:
+
Departure Date: Date:
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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
3 nights, 8 meals, tax, and state of Georgia motel fee.
PLEASE CHECK APPLICABLE RATES:
Pitts/Booth
Single: $521.07
Double: $369.21per person
Triple: $303.36 per person
Quad: $284.49 per person
FULL INDIVIDUAL PAYMENTS DUE WHEN REGISTERING.
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: Erica Bautista
P. O. Box 20407
St. Simons Island, GA 31522
Reservations must be made online.
For any additional information regarding accommodations,
please email Erica Bautista at
ebautista@epworthbythesea.org
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**