Gather & Grow Virtual Group Signup Form
Thank you for your interest in Gather & Grow! This group is for moms of two-year-olds and three-year-olds who want to learn more about child development, intentional parenting, coping with motherhood, and potentially find lifelong friends. 

Gather and Grow is intended for moms of ages 18 months to 3.5 years, and meets every other Wednesday at 1pm central time.

Each group is "come as you are" meaning there is no contract, commitment, or requirement to attend. Join when you can, and pay $45 per group session when you do. I will send an email ahead of each group to get an approximate headcount; please make every effort to respond to that email if you're joining us that week!

This form will be used for screening and to help me tailor the group to your needs. If you have any questions please feel free to email me at stacy@presentmomentcs.com

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Name *
First and last name
Email *
Where did you hear about Gather & Grow, Present Moment, Present Parent, or Stacy McCann? *
Please tell me why you're interested in joining Gather & Grow, and what you hope to get out of the group. *
How old is your child(red)? *
How do you currently feel about being a mom? *
What is your greatest struggle as a mother/parent at this time?
What topics are you most interested in discussing in group? *
Required
I understand the cost of this group is $45/session, and that I will be asked to put a credit card on file in a secure records system in order to charge after group attendance. Only after I attend the group will my card be charged, and checking this box acknowledges that I will pay for the group once attended. 
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I’ve completed this application to be considered for Gather & Grow's virtual group experience for moms of 1's, 2's and 3's. I understand that this is a coaching group and not mental health treatment. Attendance in this group does not replace mental health treatment. I understand that Stacy will determine fit for this program based on my needs.
 *
Any other comments or questions?
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