This is
*
An Assault Report
An Abuse Report
Game date
*
-
Month
-
Day
Year
Date
Referee Name
*
Referee's Phone number
-
Area Code
Phone Number
Referee's Email Address
example@example.com
Game time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Game #, if applicable
Game Type
*
Youth (8U - 19U)
Adult
Home Team
*
Name
Score
Away Team
*
Name
Score
Game Type
*
Boys/Men
Girls/Women
The Abuse/Assault was committed by:
*
Coach (Home)
Coach (Away)
Player (Home)
Player (Away)
Parent
Name of the person committing the abuse/assault
*
Age Group
*
11 U
12 U
13 U
14 U
15 U
16 U
17 U
18 U
19 U
23 U
Adult
State Association
*
League/Event
*
AR 1 Name - If one was assigned
*
AR1's Email Address
example@example.com
AR1's Phone number
-
Area Code
Phone Number
AR 2 Name - If one was assigned
*
AR2's Email Address
example@example.com
AR2's Phone number
-
Area Code
Phone Number
The United States Soccer Federation Rule 531-9 ¶(3) §(a)(i) states; “Referee assault is an intentional act of physical violence at or upon a referee. (ii) For purposes of this policy, “intentional act” shall mean an act intended to bring about a result, which will invade the interest of another in a way that is socially unacceptable. Unintended consequences of the act are irrelevant. (b) Assault includes, but is not limited to the following acts committed upon a referee: hitting, kicking, punching, choking, spitting on, grabbing or bodily running into a referee; head butting; the act of kicking or throwing any object at a referee that could inflict injury; damaging the referee’s uniform or personal property, i.e. car, equipment, etc. Rule 531-9 ¶(4) §(a) also states; “Referee abuse is a verbal statement or physical act not resulting in bodily contact which implies or threatens physical harm to a referee or the referee’s property or equipment.” Describe the incident (time, player's/coach's name, pass #, team's name, etc.)
*
Referee's Signature
*
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