Referee Red Card Report
Please complete this form to document a red card incident during a soccer match.
PERSON SUBMITTING REPORT INFO
Contact info and role of person submitting report.
Name of Person Submitting Report
*
First Name
Last Name
Email of Person Submitting Report
*
example@example.com
Cell/Text of Person Submitting the Report
Please enter a valid phone number.
Format: (000) 000-0000.
Role of Person Submitting
*
Please Select
REFEREE OF THE MATCH
ASSISTANT REFEREE OF THE MATCH
4th OFFICIAL OF THE MATCH
REFEREE ASSIGNOR ON SITE
REFEREE ASSIGNOR NOT ON SITE
OTHER
MATCH INFO
Please provide as much detail regarding the match as possible. If you do not recall or do not have the info type "do not recall" or "no info".
Match Date
*
-
Month
-
Day
Year
Date
Kickoff Time
*
Match Location
*
Match Field #
*
League
*
Age Division & Gender
*
Home Team Name
*
Away Team Name
*
INFORMATION ABOUT THE RED CARD
Please provide as much detail as possible.
Player's or Coach's Full Name (Red Carded)
*
First Name
Last Name
Player's/Coach's Team
*
Please Select
Home Team
Away Team
Retype Name of Team of Red Carded Person
*
Player's Jersey Number
*
TYPE COACH if red card was issued to a coach
Time of Incident (Minute of Match)
*
Part of the match the Red Card Issued?
Please Select
1st Half
2nd Half
PreGame
HalfTime
PostGame
Reason for Red Card
*
S1/R1: Serious foul play (ex. dangerous tackle)
SR/R2: Violent conduct (ex. punching, fighting)
S3/R3: Spitting at an opponent or another person
S4/R4: Denying a goal (Handball) or an obvious goal-scoring opportunity by handball
S5/R5: Denying a goal (Foul) or an obvious goal-scoring opportunity by a foul
S6/R6: Using offensive, insulting or abusive language and/or gestures
S7/R7: Receiving a second caution (yellow card) in the same match
R8/R9: Offense against match officials, team officials or other participants.
Other
Detailed Description of the Incident
*
Referee's Full Name (of the center official, of the match)
*
First Name
Last Name
Name of AR1
*
IF no AR was present type: "NO AR". If you do not remember the AR name state: "Do not recall name".
Name of AR2
*
IF no AR was present type: "NO AR". If you do not remember the AR name state: "Do not recall name".
Name of 4th Official
If no 4th official type NA
Name of Club Official, Assignor, or Site Coordinator, IF ANY, who witnessed or received 1st-hand account.
Referee's Email Address
*
example@example.com
Referee's Phone Number
*
Please enter a valid cell/text number.
Format: (000) 000-0000.
Submit Report
Should be Empty: