BBQ Fundraiser Order Form and Payment

6th Annual BBQ Fundraiser and Vendor Fair

Thursday May 7th, 2026

Family Life Center

South River Baptist Church

2659 S Chipley Ford Rd, Statesville NC

Eat In or Pick Up inside from 11am – 6pm

$10 per plate

(Plate includes BBQ Chicken leg quarter, slaw, beans, roll and dessert)

Place online order for Pick Up or Delivery of 8 plates or more

Online Payment Link > https://onrealm.org/headwaters/give/bbq

Headwaters BBQ Fundraiser Order Form

Current Date(Required)

MM slash DD slash YYYY

Business Name(Required)

Contact Name(Required)

First Last

Contact Phone(Required)

Contact Email(Required)

Pickup or Delivery?(Required)

Pick UpDelivery

Time for Pick Up or Deliver(Required)

Note: Delivery will be made within a 30 min window, so plates could arrive more than 30 min before requested time.

Hours

:

Minutes

AM PM AM/PM

Number of Plates Ordered(Required)

Payment Method(Required)

you can use this link to prepay for BBQ plates > https://onrealm.org/headwaters/give/bbq

We will be sending a check made out to South River Baptist ChurchWe will be bringing cash by before day of BBQWe will be paying onlineWe will contact you at 704-881-1459 to arrange payment

If Delivery, Business Address(Required)

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Special delivery instructions

(tell us who to ask for and/ or what door to deliver to upon arrival)