​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: Carloine Lebo
arnoldsuperkids@gmail.com