The Rev. James Gailliard at Word Tabernacle Church in Rocky Mount says the shooting happened Monday shortly before 6 p.m., as neighborhood teens played basketball on courts behind the sanctuary.
The pastor says he heard more than 15 gunshots and then held a boy shot in the head until authorities arrived.
The child was taken to a hospital by helicopter, where he remained in critical condition. Police said the others shot - ages 13, 17 and 19 - were treated and released.
The shooting comes just more than a week after a 15-year-old boy was shot and killed nearby.