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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=48 BGCOLOR="#006633" TEXT="#F7F7FF" bgproperties="fixed" background="0542d353.gif"> <div>  Request More Info</div> <div> </div> </td> </tr><tr> <td valign="top" width=185 BGCOLOR="#BBBBBB" TEXT="#080000" bgproperties="fixed" background="055ba253.gif"> <div> <A HREF="camp_pinehurst_out_of_camp_trips.htm" TARGET="_top" TITLE="Trips"><U><B><IMG SRC="03417140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>   </B><A HREF="camp_pinehurst_vital_information.htm" TARGET="_top" TITLE="Directions and Forms "><U><B><IMG SRC="03517140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>     </B><A HREF="index.htm" TARGET="_top" TITLE="Summer Camp in Maine, Coed, Overnight, T"><U><B><IMG SRC="03617140.gif" border=0 width="23" height="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="index.htm" TARGET="_top" TITLE="Summer Camp in Maine, Coed, Overnight, T"><U>Home</U></A></div> <div> <A HREF="sessions_and_prices_for_camp_pinehurst.htm" TARGET="_top" TITLE="Sessions and Prices for 2010"><U>Sessions and Prices for 2010</U></A></div> <div> <A HREF="tour_of_camp_pinehurst.htm" TARGET="_top" TITLE="Map and Tour"><U>Map and Tour</U></A></div> <div> <A HREF="the_4_directors_of_camp_pinehurst.htm" TARGET="_top" TITLE="Meet the Directors"><U>Meet the Directors</U></A></div> <div> <A HREF="camp_pinehurst_cabins_and_facilities.htm" TARGET="_top" TITLE="Cabins and Facilities"><U>Cabins and Facilities</U></A></div> <div> <A HREF="camp_pinehurst_land_sports.htm" TARGET="_top" TITLE="Land Sports"><U>Land Sports</U></A></div> <div> <A HREF="waterfront_activities_at_camp_pinehurst.htm" TARGET="_top" TITLE="Waterfront Activities"><U>Waterfront Activities</U></A></div> <div> <A HREF="camp_pinehurst_out_of_camp_trips.htm" TARGET="_top" 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width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> we need this to process your request!</div> <bR> <form action="https://www.startlogic.com/scripts/formsender.html" enctype="application/x-www-form-urlencoded" method="post"><table><tbody style="font-size: 12px;"><tr><td><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Parent's Name <input type="text" id="Parent Name" name="Parent Name" value="" size="30" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Camper's Name <input type="text" id="Camper Name" name="Camper Name" value="" size="30" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Boy or Girl <input type="text" id="Boy or Girl" name="Boy or Girl" value="" size="10" maxlength="1024"/> <IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Age <input type="text" id="Age" name="Age" value="" size="10" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Email Address <input type="text" id="Email" name="Email" value="" size="30" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Street Address <input type="text" id="Street Address" name="Street Address" value="" size="30" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> City <input type="text" id="City" name="City" value="" size="30" maxlength="1024"/></td></tr><tr><td><br/><IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> State <input type="text" id="State" name="State" value="" size="10" maxlength="1024"/> <IMG SRC="07c09080.gif" border=0 width="9" height="8" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> Zip Code <input type="text" id="Zip Code" name="Zip Code" value="" size="10" maxlength="1024"/></td></tr><tr><td><br/>Country <input type="text" id="Country" name="Country" value="" size="15" maxlength="1024"/></td></tr><tr><td><br/> Phone <input type="text" id="Phone" name="Phone" value="" size="15" maxlength="1024"/></td></tr><tr><td><br/>Comments or How did you hear about us?<br/><textarea name="Comments" rows="6" cols="30" maxlength="1024"></textarea></td></tr><tr><td><input type="submit" id="Form Submit" name="Form Submit" value="Submit Form"/></td></tr></tbody></table><input id="form_id" type="hidden" name="form_id" value="134214"/></form <bR> <bR> </td> </tr></table></body>