Match Incident Report Form

Match Incident Report Form

If any information is unknown please type 'Unknown' if an answer is required
Your Details
Full Name*
Role*
Email*
example@example.com
Match Details
Competition*
Home Team*
Away Team*
Division*
Venue
Date and Kick Off Time*

DayMonthYear
DateHourMinutesAM/PM Option
Reported Person Details
Person Reported
Role
Club
Players Shirt Number
Time of Incident
Incident Information
What are you reporting?*
Was the offence against a Match Official?*

YesNo
Red Card*

R1- Serious Foul PlayR2- Violent ConductR3- SpittingR4- Denying an Obvious Goal Scoring Opportunity by Use of The HandR5- Denying an Obvious Goal Scoring OpportunityR6- Verbal AbuseR7- Accumulation of 2 Yellow CardsTeam Official Specific Offences as per LOTG
Did you see the incident clearly*

YesNo
Level of Force*

High ForceMedium ForceLow Force
Further Information*

Player received medical treatmentPlayer returned to the gamePlayer didn't return to the game
Where was the contact on the body?*
Was the contact made with studs?*

YesNo
Further Details of tackle *
Please describe the tackle, did the player jump in, how many feet were used in the tackle?
Level of Force*

HighMediumLow
Offending player made contact with*
Did the player use; Hand, elbow foot etc
If fist, open or closed hand (Punch or slap)
To the opponents (Head, Neck etc)*
If a player missed, please put where it was aimed for
Did the strike connect?*

YesNo
Further information to the incident*
Did the spit make contact with someone?*

YesNo
Where did the spit make contact?*
What was said?*
Please use exact words/ phrases. Do not cut out offensive words.
Did the player commit a further offence after being sent off? (Swearing, violent conduct, refusing to leave the pitch etc)*
What was the problem with the ground?*

Weather affected - not safe/suitableField of Play not safe/suitableMarkings not acceptableOther- (Give details below)
When did the incident occur?*

Pre gameDuring gamePost game
Reason for abandoned match*

Home team not in attendanceAway team not in attendanceWeather affectedSpectator interferenceLight failure or insufficient for playOther
Other report options*

Colour ClashMatch starting lateReport on facilitiesOther not listed
Please add any extra information regarding the incident
Please enter any comments/ extra information you wish to add to this report.
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Match Incident Report Form

Your Details

Match Details

Reported Person Details

Incident Information