Referee Game Reports

FYSA Game Report

Please answer the following questions about the game you were a referee for. Bookmark this page and submit one for each game. Since we don't all work in the same location at the same times, this report acts as your time sheet for the purpose of being paid for the games you officiate. If you have any questions, please contact FYSA Executive Director Colt Chase at director@fairbanksyouthsoccer.com office phone # 907-456-3972 or cell (call or text) 907-378-7273

Question Title

* 1. Please enter your name and contact info.

Name

Phone

Question Title

* 2. Please enter the date and time of the game for which you are reporting.

Date / Time

Date

Time

AM/PM

Question Title

* 3. Please select the location of this game.

Ryan Middle School

Tanana Middle School OLD Gym

Tanana Middle School NEW Gym

Randy Smith Middle School

Woodriver Elementary

Anne Wien Elementary

Other (please specify)

Question Title

* 4. Please select the age group for this game.

K1: Kindergarten-1st Grade

23: 2nd-3rd Grade

45: 4th-5th Grade

MS: Middle School

HS: High School

Question Title

* 5. Please enter the following information for this game.

Home Team #

Home Team Jersey Color

Home Team Score

Away Team #

Away Team Jersey Color

Away Team Score

Question Title

* 6. Were any cautions or send-off's (yellow/red cards) issued?

Yes, Home Team

Yes, Away Team

If 'Yes', please provide the following information: Team, player # and/or name, time, type of misconduct and detailed description of the incident. (example: Team HS09, #8 Bobby Smith, 32nd min. Caution for persistent infringement: #8 had repeatedly committed tripping fouls and had been warned repeatedly)

For red cards or other serious misconduct, please also contact FYSA office to confirm.

Question Title

* 7. Anything else to report from this game? Serious sportsmanship concerns, awesome goal, funny incident, difficult reffing decision, etc. (This question is not required, but use this space to communicate anything additional about the game that you might feel inclined to)

THANK YOU FOR SUBMITTING YOUR GAME REPORT!