April 16, 17, 18, 2010 Pine Hill Campground 268 Old Route 22 Kutztown, Pa. 19530

Name ______________________________ Phone # ______________Rig Length ___

Camping Fee   $  80.00 (30) amp service 

                        $  84.00 (50) amp service

Extra Night       $________  You Need To Contact Campground Direct

Guests            $________  4.00 per person plus camping fees.

Guests Under Twelve (12) no charge, but need number for count  ________

Total                  $________

Going to Dinner Saturday Evening:      Yes      No      How many ____

Send Reservations/Checks made payable to Bill Gallagher 779 Fir Dr. Walnutport, PA. 18088

If you are assigned to a 50 Amp site you will be charged for that rate regardless of what you use. We should have plenty of 30 Amp sites for those that wish this serviceIf we get 10 or more rigs we will get a 10% discount which the rally master will refund to you at the rally.
Date of Arrival __________ Date of Departure __________
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