Please fill out Incident Report in Full
ATTENTION GAME OFFICIAL: The CCS and NCS have high expectations of players, coaches and fans regarding sportsmanlike behavior. In order to monitor these expectations, we need your assistance. This form is REQUIRED to be completed and returned to your Commissioner of Officials in the event of any:
DISQUALIFICATION (game exclusion), PENALTY OR EJECTION for flagrant, unsportsmanlike conduct, bench fouls or other misconduct of a serious nature committed by anyone associated with a contest you officiate. It is our expectation that you will enforce all rules related to player and coach behavior. Players who's action requires the submission of an incident report are subject to suspensions in accordance with CCS and NCS policy. Therefore, the filing of this report within 24 hours is important.
This form is REQUIRED to be filed within 24 hours of any incident (such as described above as well as on page two of this form where you will find specific CCS or NCS by-law language) during any pre-season, league or CCS or NCS Playoff contest in which any CCS or NCS member school is participating. The MACPOLO Assignor shall forward this report electronically to the CCS and NCS Office as soon as possible after it has been submitted.
ACCIDENTS OR INJURIES must be reported on incident reports, but will not be submitted to CCS or NCS unless requested.
Date of Report
-
Month
-
Day
Year
Date Picker Icon
Sport: WATER POLO
Gender/Level
Please Select
BOYS: High School
GIRLS: High School
MEN: Community College
WOMEN: Community College
USWP
Governing Body
NCS
PAL
COAST JC
Other or Don't Know
Date of Incident
-
Month
-
Day
Year
Date Picker Icon
Visiting Team
Home Team
School involved in misconduct
Submitted by: MAC POLO Referees' Association
Please fill in all fields
IDENTIFICATION: (e.g. player's name, cap no.; head coach, assistant coach; or physical description of person (s) charged with misconduct.)
Name of person described above
Name of official
Official's Email address
ADMINISTRATOR
Was administrator at contest?
Yes
No
Don't know
If yes, was adminstrator made aware of incident?
Yes
No
Don't know
Have you had similar incident with this school previously?
Yes
No
Don't know
Medical Incident
Please Check All That Apply
Suspected Concussion
Other Injury
Player Removed from Game
Player's Name
Quarter and Time of Incident
Describe Incident in Detail
Game Cancelation
Reason for Cancelation
Weather
Electrical Failure
Other
Quarter and Time of Cancelation
Describe Circumstances in Detail
Misconduct Incident
Referee Action Taken
Misconduct
Flagrant Misconduct
Red Card
Other (explain below)
Rules violated - Site page, rule, section, article and write out the text of the rule
Player Behavior
Cooperative
Courteous
Abusive
Hostile
Sarcastic
Profane
Other (explain below)
Describe
Coach Behavior
Cooperative
Courteous
Abusive
Hostile
Sarcastic
Profane
Other (explain below)
Describe
Determination of type of violation and/or action taken by official
Spectator Interference
Unsafe Facility CIF Bylaw Physical Assault
Flagrant Unsportsmanlike Behavior
Lack of cooperation/concern
"Bench Foul" Disqualification (RED CARD) (please ID person DQ'd)
Other (please explain below)
Name of person disqualified
Ejected from contest
Ejected from contest
Name of person ejected
Please describe this incident in your own words
Comment (Include explanation)
Please submit to your assignor no later than 24 hours after the incident. Each Commissioner shall immediately forward this via Email or fax to the CCS or NCS Commissioner, who will in turn notify the appropriate league Commissioner and both principals.
My Products
prev
next
( X )
Payment Method
Credit
Express
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
Expiration Year
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lesotho
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Other
Country
Submit
BYLAWS, SPORTSMANSHIP SECTION: PLAYERS EJECTED FROM CONTEST (a) In all contests prior to CCS or NCS Playoffs, any player ejected from a contest for unsportsmanlike behavior will be disqualified from participating for a minimum of one contest, with such disqualification taking effect at the team's next contest. If the contest from which the player was ejected is the last contest of the year for that team, the above-stated disqualification would carry over to that team's first (1st) regularly scheduled league contest the following year. Any such player who participates in the next contest following his/her ejection will be treated as an ineligible player for that contest. Any player may appeal the disqualification to his/her respective League. Each League shall establish appellate procedures pertaining to the eligibility of student-athletes who are ejected from an interscholastic contest. (b) Any player ejected from any CCS or NCS Play-off contest because of flagrant misconduct or unsportsmanlike behavior shall be excluded from participating in the remainder of the playoff contests in that sport during that season. Official(s) ejecting the player will automatically be required to submit a written report to the CCS or NCS Commissioner. Any school principal may appeal the disqualification to the CCS or NCS Commissioner if they believe that the student was ejected due to an error in identification or do not believe the student was ejected as a result of flagrant misconduct or unsportsmanlike behavior. The CCS or NCS Commissioner, in conjunction with the League Commissioner for that school, shall review the case and make a final determination.SECTION: COACHES EJECTED FROM CONTEST (a) In all contests prior to CCS or NCS Play-offs, any coach ejected from a contest for unsportsmanlike behavior will be disqualified from any coaching activities for a minimum of one contest, with such disqualification taking effect at the team's next contest. If the contest from which the coach was ejected is the last contest of the year for that team, the above-stated disqualification would carry over to that team's first (1st) regularly scheduled league contest the following year. Any such coach who engages in any coaching activity in the next contest following his/her ejection will be referred to his/her League for disciplinary action, and the contest in which his/her team competed will be subject to forfeiture. Any coach may appeal the disqualification to his/her respective League. Each League shall establish appellate procedures pertaining to coaches who are ejected from an interscholastic contest. (b) Any coach ejected from any CCS Play-off contest because of flagrant misconduct or unsportsmanlike behavior shall be excluded from participating in the remainder of the playoff contests in that sport during that season. Official(s) ejecting the coach will automatically be required to submit a written report to the CCS or NCS Commissioner. CIF BYLAW 522. PHYSICAL ASSAULT: Any student who physically assaults the person of a game or event official shall be banned from interscholastic athletics for the remainder of the student's eligibility. A game or event official is defined as a referee, umpire or any other official assigned to interpret or enforce rules of competition at an event or contest. A student may, after a lapse of 18 calendar months from the date of incident, apply for reinstatement of eligibility to the State Executive Director. INCIDENTS OCCURING IN VIOLATION OF THESE BYLAWS OR GENERALLY ACCEPTED STANDARDS OF SPORTSMANLIKE BEHAVIOR IN ANY CCS or NCS HIGH SCHOOL CONTEST (pre-season, scrimmage, league games, CCS or NCS Playoffs) MUST BE REPORTED AND SUBMITTED TO THE CCS or NCS IMMEDIATELY BY THE COMMISSIONER OF OFFICIALS! THANK YOU FOR YOUR COOPERATION!
Should be Empty: