Growing Great Families - Class Enrollment Form
First Name *
Your answer
Last Name *
Your answer
In which class are you enrolling? *
I am a childcare provider and would like STARS credit for attending this class. *
If yes, at which childcare center or for which organization do you work?
Your answer
Payment Options - please select one from the following choices:
Payment Options - please select one
(if you are enrolling as a couple, make sure your partner fills out an enrollment form)

- $30/person
- $25/person - I am a JH Children's Museum member
- $45/couple
- Pay what you can (please indicate the amount you can pay in the "other" box. No questions asked!)

Payment Options - please select one *
Email Address *
Your answer
Phone number *
Your answer
Age(s) of your children
Please enter the age of your child/children below. (Note - there is an option to indicate that you do not have children)
Child 1: *
Child 2:
Child 3:
Child 4:
Child 5:
Mailing address
Your answer
Your answer
Zip Code
Your answer
Where did you hear about this class? *
Click all that apply. Please add specifics in the "other" category. For example, where you saw the flyer; at which preschool you heard about the class; or if you found out about the class in a different way.
Payment is expected by the first class in the form of cash, Venmo transfer (@Rachel-Wigglesworth or 307-732-0413), or check made out to Rachel Wigglesworth. To secure your spot, please indicate your payment plans below. Checks can be mailed to:
Rachel Wigglesworth
3415 Appaloosa Dr.
Jackson, WY 83001
I will pay by: *
What are your particular challenges? What are you hoping to get out of this class? Any other comments? (and please indicate your partner's name if you are enrolling as a couple)
Your answer
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