RCRC Rower Information

Participant Info

Rower's Information
Rower's First Name
Joshua
Rower's Last Name
Macri
Preferred Name
Josh
Rower's Full Mailing Address
104 Kensington Dr Madison, AL 35758
Rower's Phone
571-331-2327
Select Rowing Group
High School/Competitive
USRowing Membership Number
1520675
USRowing Membership Expiration Date
August 30, 2022
USRowing SafeSport
My rower is under 18 years of age
Rower's Birthday
08/25/2007
Rower's Age
14
Rower's Current School
Homeschool
Rower's Current Grade Level
8th
Rower's Height
5,2"
Rower's Weight
94
Rower's Photo

Personal Info

Parent/Guardian(s) & Emergency Contact's Information
Parent/Guardian's Name
Jennifer Macri
Parent/Guardian's Phone
571-331-2327
Parent/Guardian's Email
jenannm AT yahoo.com
Parent/Guardian 2 Name
Joe Macri
Parent/Guardian 2 Phone
256-690-2013
Parent/Guardian 2 Email
macrija AT gmail.com
Who should be contacted in case of an emergency?
Parent/Guardian 1
Emergency Contact Name
Megan Lockwood
Emergency Contact Phone
619-861-8387
Rower's Medical & Safety Information
Select Medical Conditions
None of the issues listed here
If a medical condition was selected, please explain here.
List known Allergies
NA
List any other known Medical Conditions
NA
Rower is Physically Able to Row
Yes
Primary Care Physician's Name Name
Dr Johnson
Primary Care Physician's Number
256-461-7440
Medical Insurance Provider
Compass Rose UHC UMR
Medical Insurance Contract/ID #
Y15280805
Medical Insurance Policy/Group #
76-411449
Permission to Provide Emergency Care
Yes
Rower has completed an RCRC Swim Test
Yes
When will I Upload the Physical
Rower has completed physical and will or has uploaded the form
RCRC WAIVERS
RCRC Waivers: Please read and check the boxes to agree to the following waivers below: Participation Waiver, Liability Relating to Coronavirus/COVID-19 Waiver, Carpool Release, & Youth Media Release.
Participation Waiver
Yes
Waiver of Liability COVID-19
Yes
Carpool Release Agreement
Yes
Youth Media Release Agreement
Yes
Other Information
Where did you hear about RCRC's Rowing Program?
RCRC Rower or rowing family
Signature
Jennifer Macri
Oct. 16 & 17 Regatta
Both Days
Nov 13 Regatta
Attend
**WHAT TO DO IF YOU SELECT THE WRONG IMAGE/FILE WHEN UPLOADING**
Once you select an image/file to upload, you have to save it before you can change it. Ex. You select an image of the physical's 2nd page where the 1st page should be:  click save - delete it - and attach it in the right place.
Provide the date the physical was performed (on the physical) & Upload both pages of your physical as either: Two images - one of each page (jpeg preferred) or One document (pdf preferred) with both pages.
Date Physical Was Performed
September 3, 2021
IMAGE - upload Physical Form Page 1 of 2
IMAGE - upload Physical Form Page 2 of 2
FILE - upload Physical Form
Upload the signed page of the Youth Conduct as either an image or file & Upload the COVID-19 Rules of Conduct Contract as either: Two images - one of each page or One document with both pages. (jpeg & pdf preferred)
IMAGE - upload Youth Conduct Code Page 1 of 1
FILE - upload Youth Conduct Code
IMAGE - upload COVID-19 Rules of Conduct Contract Page 1 of 2
IMAGE - upload COVID-19 Rules of Conduct Contract Page 2 of 2
FILE - upload COVID-19 Rules of Conduct Contract
---------->
Help RCRC Out: After you upload a form, check the corresponding box below. This will help us keep track that each rower has uploaded all the documents needed to finish the registration process. Thanks!
I have completed my forms!
Physical, Youth Conduct Code, COVID-19 Waiver