Epworth By The Sea • St. Simons Island, Georgia
Tuesday, October 18, 2022 - Thursday, October 20, 2022
Address Line 2
Departure Date: Date:
Number Adults in Room:
My room is being paid for by:
I am paying for how many people?:
Special Request (Diet, disability, etc):
Roommate Request: (Roommates other than family, complete separate form.)
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:
Single Occupancy: $356.72
Double Occupancy: $242.40 per person
PLEASE INCLUDE $50.00 DEPOSIT PER PERSON WITH YOUR RESERVATION.
Make check payable to Epworth By The Sea
Or Submit Credit Card Information Below:
Online reservations must be paid for by credit card only.
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:
Epworth Cancellation Policy:
Full refund prior to Tuesday, October 4, 2022.
After October 4, 2022, any individual cancellation will result in forfeiture of $40 per person.
Cancellations within 72 hours of arrival will forfeit first night’s charges per person.
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 Renthia Lewis at
or call 912-638-8688.
**PLEASE PRINT THIS FORM FOR YOUR RECORDS BEFORE SUBMITTING.**