BRUNSWICK STEW PICK UP 10:30am

January 24 @ 10:30 am

YOUTH FUNDRAISER!! BRUNSWICK STEW $10 PER QUART…CALL THE CHURCH OFFICE TO PRE-ORDER – 336-449-4512

PICK UP TIME 10:30

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Child's Name*

Parent/Guardian Name*

Email*

Phone: indicate home/cell*

Address*

Age*

Last Grade Completed*

FOOD ALLERGIES & MEDICAL INFORMATION*

Emergency Contact include name & phone number*

Dismissal Information include name & phone number*

Guest of

May we have permission to photograph your child?*

May we have permission to use your child`s photograph for the purpose of promotion?*

T-Shirt Size Youth/Adult(Y) XS,S,M,L or (A) S, M, L, Xl, XXl, etc.*

What is 3 + 2*