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Racing Canoe Center
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COVID-19 Vaccine Verification
COVID-19 Vaccine Verification
Astrid
2021-09-10T20:56:41-07:00
Contact COVID Coordinator
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Contact our COVID Coordinator
Contact COVID Coordinator
First Name
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Last Name
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Subject
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Message to COVID Coordinator
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Submit
COVID Vaccine Verification
COVID-19 Vaccine Verification for BRCC
Following recommendations from the City of Berkeley and other local institutions - BRCC has decided that we will collect verification of Covid vaccine. Please anser the following question and attach/upload evidence of vaccination.
Paddler's First Name
*
Paddler's Last Name
*
BRCC Affiliation
*
Dragon Max
Cal
Rough Rider
No Team Affiliation - small vessel user
Other
Other
Date of Vaccination
date of second shot for Pfizer/Moderna, date of single shot for J&J
Please upload your proof of vaccination (vaccine card or QR code provided by the state of CA)
Drop a file here or click to upload
Choose File
Maximum upload size: 67.11MB
If you are human, leave this field blank.
Submit Vaccine Verification
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