Housing Form for Epworth By The Sea
Thursday, October 26, 2023 - Saturday, October 28, 2023
Address Line 2
Roommate other than family, please complete separate form.
Number of Adults in Room:
I am paying for how many people?
My room is being paid for by:
Special Request (Diet, disability, etc):
Departure Date: Date:
Rates listed below are per person based on the number of adults staying in the room together, and include lodging for 2 nights and 6 meals, state of Georgia motel fee and taxes. Meals start with Thursday supper and go through Saturday lunch.
PLEASE SELECT FROM THE FOLLOWING ACCOMMODATIONS:
Double: $234.60 per person
Triple: $195.40 per person
Quad: $185.16 per person
Number Children in Room with Adult (age 3-12) - $57.30 per child:
Number of Teens in Room with Adult (age 13-17) - $126.98 per child:
Please include total payment with reservations by October 5, 2023.
Make check payable to Epworth By The Sea.
Or Submit Credit Card Information Below:
There is a 3% Credit Card Transaction Fee on payments over $1,000.
Name on Card
Credit Card Type
Amount To Charge:
NOTE: IF PAYING BY CHECK PLEASE PUT "N/A" IN THIS SPACE!
Expiration Date (mm/yy)
3 Digit Security Code:
Billing Address Zip Code:
I am authorized to make these credit card charges:
EPWORTH CANCELLATION POLICY:
Any individual cancellation after October 5, 2023 will forfeit the first night’s rate.
Any individual cancellation after 72 hours of arrival date will forfeit the entire per person charges. .
Reservations not accepted by phone but may be mailed, faxed, or emailed to the information below.
Please submit this form online or you may print and 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, contact Renthia Lewis:
email@example.com or 912-268-4835
* 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.
This form is for Epworth By The Sea ONLY.
**PLEASE PRINT A COPY FOR YOUR RECORDS BEFORE SUBMITTING**