On-field and Off-field Incident Report Form 2025/26
This form is to enable individuals to report both on-field rule breaches which result in expulsions, in addition to breaches/violations of the England Lacrosse Code of Conduct/RESPECT code that occur off-field. Additional fields will appear as relevant as you progress and input information. If an injury occurred due the incident being reported, please include details in the text box, if a stand-alone injury incurred with no on-field rule breach please submit via the Injury Report Form. If you have any problems using the form or enquires as to the processes which will follow submission of the form please email: disciplinary@englandlacrosse.co.uk.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Please select which type of incident you are reporting
Please Select
On-field Rule Breach/Respect Code Violation
Off-field Code of Conduct/Respect Code Violation
Date and Start Time of Game
-
Day
-
Month
Year
Date
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
Which of the following best describes the game?
*
North Men/Boys
South Men/Boys
Midlands Men/Boys
National Men/Boys
North Women/Girls
South West Women/Girls
South East Women/Girls
National Women/Girls
Sixes
Indoor North
Indoor South
Indoor National
Mixed
BUCS Men
BUCS Women
University Other Men
University Other Women
Schools
Other Men/Boys
Other Women/Girls
Please indicate if the game was a Junior or Senior Game
Please Select
Junior
Senior
If applicable what Division/ Event was the game?
i.e. SEWLA Premiership, NWLA U14 Boys,
Please provide a brief reference as to the reason for the report submission (a comprehensive overview will be requested in a later question.
Home Team
*
Enter Home Team name
Away Team
*
Enter Away Team name
Head/ Lead Official
*
Enter Head/Lead Officials Name
Second Official's Name
*
Third Official's Name
If No Third Official type 'None'
CBO
If no CBO type 'None'
Which Official gave the decision?
*
Name the Official that witnessed the incident
Name of individual being reported
*
If Person is unknown or has not been identified type 'Unknown'
Which team was the individual being reported representing?
If Person is unknown or has not been identified type 'Unknown'
Player's Shirt Number
*
If player is Unknown type 'Unknown'. If Person being reported is not a player enter 'N/A'
If an expulsion was issued, was the player/their club made aware of the minimum 1 match suspension from one of the officials?
*
Please Select
Yes
No
N.A
Please give as many details of the incident as possible including specific rule breach/violation plus any aggravating or mitigating factors to be reviewed by the appropriate disciplinary body. If any injuries occurred as a result of the incident, please include details here.
*
Please give as many details of the incident as possible which include the individual/organisation you are reporting, the location if physical or online of the incident and then also any aggravating or mitigating factors to be reviewed by the appropriate disciplinary body.
*
Submit
Should be Empty: