Match Official Send-Off Report

Match Official Send-Off Report

Match Details

Home Team

VS

Away Team

League

Age Group

Division

Ground

Date & Kick off time

DayMonthYearHourMinutesAM/PM Option

Player Details

Player Name

First NameLast Name

Shirt Number

FFA Number

Club Name

Offence Details

Send-Off Offence

NOTE: IF NECESSARY, A POST SEND-OFF INCIDENT REQUIRES A SEPARATE INCIDENT REPORT.

Time of offence

Enter minute of game (eg: 74)

Score at time of offence

Enter score (eg: 1-2)

The Lead-up to the Send-off Incident:

Describe where play was; What type of play?; Did anything happen in the Lead-up that made the incident occur? If you were the Assistant Referee, which side were you on (near/far to play)?

The Lead Up

The send-off was the result of the player’s following actions (Describe the incident):

R1: Distance from Opponent; Speed; Force; Lunge; Studs Showing etc.

- Attempting to gain possession of the ball using excessive force?

- Conduct that endagers the saftey of an opponent in a contest for the ball or has potential to cause injury?

- Conduct causing injury? What was the injury?

R2: Describe Contact: Open palm slap; Closed Fist Punch; Right Elbow. Describe the Force Used.

- Was the opponent injured, if so, describe the injury.

R3: Where did the spit land?

- Was it towards the referee or another player?

R6: What were the exact words that were said?

- How loud was it? Audible from the sideline? Any young children in vicinity?

The send-off was the result of the player’s actions

As a result of the offender's actions, what happened to the opponent (Describe in detail):

- Was the opponent affected by the offender's actions; Could you see any physical marks (blood, bruising, stud marks)

- Did they require treatment

- Were they able to continue playing or did they need to come off the field for a period of time

- Were they not able to return to the field as a result of the offender's actions

What happened to the opponent

Your (The Referee's) position and view of the incident:

How far where you from play? What angle or view of the incident did you see? Was your view clear or obstructed?

The Referee's Position

Post Send-Off

Did the player continue to misbehave (further incident) after the Send-off? If so, describe briefly what occured.

Did the player leave the field without further incident?; How was play restarted?

If extensive, also submit an incident report (compulsory)

Post Send Off

Any Supporting Documents and Evidence (upload any photos of injuries if taken)

Browse Files

Match Official Details

Role

Your role

Your Name

First NameLast Name

Your E-mail

A copy of your submission will be emailed to this email account.

Were you under 18 at the time of the match?

If you were U18 at the time of the offence, the participant will receive a greater suspension

Digital Signature

Submission Date

DayMonthYear

Send Off Reports must be submitted by no later than 6pm on Monday following the match.