Welcome to Culver-Stockton College Women's Youth Basketball Camp Application
Grades 3 - 7
Dear Campers and Parents,
The Culver-Stockton College Women's Basketball team would like to invite you to three days filled with basketball, fun, and friends.
The camp will be run by Janette Burgin, head women's basketball coach and Terra Helm, assistant basketball coach, and Wildcat players.
This is a great opportunity for players to work with a college coaching staff and for players to help build proper fundamentals and become a better basketball player. We look forward to meeting and working with you at our upcoming camp.
Janette Burgin, Head Coach
When you click the submit button on this form, it will direct you to the credit card site to enter your payment information. Camp applicants may be completing this form in a school setting and not have access to credit card information at that time. To avoid duplication of camp applications, please answer No and return to the form at a later time to complete your application. Thank you.
Click the link to download the 2021 Camp Brochure
Youth Camp Goal:
The goal of the Culver-Stockton Wildcat Youth Camp is to teach fundamental skills and team concepts necessary for each participant to become a more complete player.
The day will consist of a traditional camp format with skill stations, contests and games.
To reserve your spot, please complete the registration form and submit it with a minimum $40 deposit by May 27, 2021. Please note, option to pay full camp payment is also available on the Camp Deposit/Payment tab.
Sunday, June 6 - Check in 2:00 p.m./Commuter pick up at 7:00 p.m.
Monday, June 7 - Commuter drop off 8:00 - 8:30 a.m. / pick up at 7:00 p.m.
Tuesday, June 8 - Commuter drop off 8:00 - 8:30 a.m. / pick up at 12:00 p.m.
Camp ends at 12:00 p.m. on Tuesday, June 8
I will be attending as a:
Enter your home address information:
Emergency Phone #:
Please select the Grade you will be entering next year:
Residential Youth campers will receive breakfast/lunch/dinner. Commuter Youth campers will receive lunch/dinner.
List any Food Allergies (if applicable):
Signature and Release
The following statement must be signed by the parent/guardian of the camper. By typing your name in the field below, you acknowledge that the form is complete/accurate and you are certifying your understanding of the statements below. Furthermore you agree your name in the box constitutes an electronic signature authorizing the college to take action in the event of an emergency.
I hereby release Culver-Stockton College and its employees from all claims on account of any injury which may be sustained by my child as a result of participating in the Culver-Stockton Women's Basketball Camp.
Furthermore, I certify that within the past year my child has had a physical examination and that she/her is physically able to participate in basketball activities. In the event of illness or injury, I hereby give consent for medical treatment and permission to the attending physician to hospitalize, secure proper treatment, and order injections, anesthesia, or surgery.
It is further understood that if an accident occurs, the parents primary insurance will provide the necessary care.
Name of Participant:
Age of Participant:
Thank you for completing the Women's Basketball Summer Camp Application. Your application will not be complete until a successful deposit payment has been made. Please click the button below to secure a spot in the camp. Failure to complete the online deposit payment will nullify this application. Any questions, please contact the C-SC Athletic Office.
REMEMBER in order for your place to be secured in the Summer Camp you must complete, at minimum the deposit amount, and your credit card payment be approved.
Please select amount to pay: