​Super Kids' Place Registration Form (Arnold)

Child's Name ___________________________________________

Date of Birth ____________________________________________

Date of Enrollment ___________________Grade___________________

Phone____________________ Cell Phone_________________

Work Phone_____________________________________

Parent's name(S)__________________________________

Address _______________________________________

________________________________________

Email address_______________________________________


Indicate which program your child(ren) are registering for:

Before School (5 day) __________   Before School (3day) M T W Th F
Afternoon (5 day) ____________     Afternoon (3day) circle M T W Th F

I would like to register my children for enrollment in the program. I have
attached the $60.00 non-refundable registration fee.  

Parents signature__________________________________Date_____________

Email to :
Super Kids' Place
95 Joyce Lane East
Arnold Md 21012
410-271-7480
Director: Karen
arnoldsuperkids@gmail.com