Growing Great Families - Enrollment Form
Please use this form to enroll in
** Toddlers, Preschoolers & Tantrums (find more info here:
https://growinggreatfamilieswy.weebly.com/toddlers--tantrums.html
)
** Raising Teens - a 6 week class (find more info here:
https://growinggreatfamilieswy.weebly.com/raising-teens.html
)
Questions? Email
GrowingGreatFamilies@gmail.com
* Required
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
In which class are you enrolling?
*
Please choose your class below. All times are in Mountain Time
Toddlers & Tantrums: Feb 17, 2021 -- 5:30-7:00 pm MST (TT_2/17/21)
Toddlers & Tantrums: Feb 25, 2021 -- 1:15-2:45 pm MST (TT_2/25/21)
Raising Teens: Wednesdays starting Fed 24, 11:30 am MST for 4 weeks (RT_day_2021W)
Payment Options - please select one from the following choices:
- $20/person for Toddlers & Tantrums
- $125/ person for Raising Teens
- Sliding scale available - see below
Payment is expected upon enrollment in the form of Venmo transfer or credit card using Square. To secure your spot, please indicate your payment plans below:
I will pay by: (payment option links will appear once you submit this form)
*
Venmo - transfer made prior to class (@Rachel-Wigglesworth,
rachelwigg@gmail.com
, or 307-732-0413). Please indicate which class you are enrolling in when you pay by Venmo
Credit card (link will be provided once form is submitted)
Other:
Required
Payment Options - please select one ($20 for Toddlers & Tantrums ... $125 for Raising Teens)
*
Please use "Other" option if you need a sliding scale and indicate the amount you will pay
$20
$125
Other:
If paying by Venmo, you can use this picture to verify you have the correct Rachel Wigglesworth :)
Parenting Challenges
Optional: Please give Rachel some ideas of the challenges you are working on with your child(ren) at home.
What are your biggest parenting challenges? What are you hoping to get out of this class? What topics would you like to see covered? Any other comments?
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:
*
Choose
No children
Baby on the way!
0-6 months
7-12 months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
older than 18
Child 2:
Choose
No children
Baby on the way!
0-6 months
7-12 months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
older than 18
Child 3:
Choose
No children
Baby on the way!
0-6 months
7-12 months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
older than 18
Child 4:
Choose
No children
Baby on the way!
0-6 months
7-12 months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
older than 18
Child 5:
Choose
No children
Baby on the way!
0-6 months
7-12 months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
older than 18
Where do you live?
City
Your answer
State
Choose
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
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.
Growing Great Families' website
Growing Great Families' mailing list/email
Newspaper (Jackson Hole News & Guide)
Facebook - Growing Great Families' page or Rachel's personal page
Facebook - Vicki Hoefle's page
Friend
Web search
My day care/ preschool/ school
Flyer
Other:
Would like to receive Growing Great Families' periodic and infrequent newsletters to read Rachel's blogs and hear about class offerings?
Yes
No
Clear selection
Thank you! Payment links and other details will appear once you hit "submit".
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