United Women in Faith - South Georgia
Epworth By The Sea • St. Simons Island, Georgia
Friday, March 21 - Sunday, March 23, 2025

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.
Roommate form MUST BE SUBMITTED ON THE SAME DAY as this form!

Check box if Roommate will pay separately:

Roommate pays separately

Number 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:

Pitts/Booth

Single Per Person: $337.98

Double Per Person: $234.40

Triple Per Person: $188.16

Quad Per Person: $173.24

PLEASE INCLUDE TOTAL PAYMENT WITH 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.
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:
Full payment due with reservation by Friday, March 7, 2025.
Any cancellation after Friday, March 7, 2025 will forfeit $50.00 per person.
Any cancellation after Monday, March 17, 2025 will result in the forfeiture of the first night per person 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.

United Women in Faith - South Georgia Epworth By The Sea • St. Simons Island, GeorgiaFriday, March 21 - Sunday, March 23, 2025

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 INCLUDE TOTAL PAYMENT WITH RESERVATIONMake check payable to Epworth By The Sea

Or Submit Credit Card Information Below:Online reservations must be paid for by credit card only. There is a 3% Credit Card Transaction Fee on payments over $1,000.