Form

Please register so we have enough space and materials available:

Pontotoc County Community Gathering Registration

Wednesday, April 3rd 12:00pm to 1:00pm

H20 Church
16615 CR 1560, Ada, OK 74820

If your church has NOT enrolled in CarePortal and would like to learn more please click here.

First name*

Last name*

Email*

Phone number*

Organization or Church Representing*

Organization or Church Role*

Name of guest(s) or church member(s) you wish to invite

Are there any specific questions you may have or topics that may be helpful to you?