Cook the macaroni according to the package directions in lightly salted water, leaning toward the al dente side. Do not overcook!
Put the cream, butter and garlic clove into a Dutch oven and heat on the stove over low heat. When the cream is hot, add the fontina, goat cheese, Parmesan and Romano.
Drain the macaroni (reserving some of the cooking water if needed) and add it to the pot. Stir gently to combine, adding hot macaroni water as needed for consistency. Don't overmix; if there are little clumps of cheese here and there, it's fine! Taste and add about 1/2 teaspoon salt if needed. Add some pepper and minced parsley and stir. Serve immediately.
If you are eating it later, turn the mixture into a large, buttered ovenproof dish. Sprinkle over some extra grated fontina and bake at 350 degrees F until bubbly and golden on top, 20 to 25 minutes. Sprinkle with parsley and serve.