HCCF SEND OFF REPORT
Your Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Role
*
Please Select
Referee
Assistant Referee 1
Assistant Referee 2
4th Official
Other
If other, please specify
Match Details
Please provide details of the match here, some of this information can be found on the Official Team Sheet.
Date
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Minute of Send off
*
Competition
*
Please Select
Saturday
HCCF Cup
Steel City Challenge
Iuliano Campbell Cup
Ian Pettigrew Shield
Other
If other, please specify
Division
*
Home Team
*
Away Team
*
Venue
*
Field Location
Details of Send Off
You will now be guided through a series of questions relating to the send off offense.
Player Name
*
First Name
Last Name
Club
*
Was the offense committed by a Player or Team Official?
*
Please Select
Player
Team Official
Code
*
Please Select
R1 - Is guilty of serious foul play.
R2 - Is guilty of violent conduct.
R3 - Spits at an opponent or any other person.
R4 - Denies an opponent a goal or an obvious goal scoring opportunity by deliberately handling the ball.
R5 - Denies an obvious goal scoring opportunity to an opponent moving towards the player’s goal by an offence punishable by a free kick or a penalty kick.
R6 - Uses offensive or insulting or abusive language and/or gestures.
R7 - Receives a second caution in the same match.
Yellow 1 Code
Please Select
Y1 - Is guilty of unsporting behaviour.
Y2 - Shows dissent by word or action.
Y3 - Persistently infringes the Laws of the Game.
Y4 - Delays the restart of play.
Y5 - Fails to respect the required distance when play is restarted with a corner kick, free kick or throw-in.
Y6 - Enters or re-enters the field of play without the Referee’s permission.
Y7 - Deliberately leaves the field of play without the Referee’s permission.
Time given
Yellow 2 Code
Please Select
Y1 - Is guilty of unsporting behaviour.
Y2 - Shows dissent by word or action.
Y3 - Persistently infringes the Laws of the Game.
Y4 - Delays the restart of play.
Y5 - Fails to respect the required distance when play is restarted with a corner kick, free kick or throw-in.
Y6 - Enters or re-enters the field of play without the Referee’s permission.
Y7 - Deliberately leaves the field of play without the Referee’s permission.
Time given
Description of Send Off Charge
*
SEND OFF - Where were you in relation to the incident? Use the pencil Icon to mark with "X" YOUR position and "O" for position of incident. If you make a mistake press clear to start over.
*
Did the player or team official leave the field of play without further incident?
*
Yes
No
Description of After Send of incident
*
Please verify that you are human
*
Submit
Should be Empty: