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: Jade Bullough
arnoldsuperkids@gmail.com
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: Jade Bullough
arnoldsuperkids@gmail.com