Zone 4: Lakewood Soccer Association Tournament Misconduct Report

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* 1. Referee:

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* 2. Game Date

Date / Time

Date

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* 3. Game:

Date / Time

Date

Time

AM/PM

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* 4. Field:

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* 5. Gender:

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* 6. Age Division:

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* 7. Division:

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* 8. Home Team (i.e Lakewood Eagles):

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* 9. Away Team (i.e Aurora Stars):

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* 10. Player:

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* 11. Jersey Number:

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* 12. At the _ min of the _ half the player was ejected for:

Players and/or Team Personnel Misconduct - Please check one, or more, boxes to accurately describe the actions of the player

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* 13. Received two (2) Cautions

Not Applicable

Unsporting Behavior (USB)
Dissent by word or action
Persistent infringement of the laws of the game
Delaying the restart of play
Failure to respect the required distance
Entering or re-entering the field of play without the referee's permission.
Deliberately leaving the field without the referee's permission.

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* 14. If they received two (2) cautions, what were the cautions for (if applicable)?

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* 15. Serious Infringements of the FIFA Laws of the Game (sending off offenses): Misconduct Against Opponents or Persons other than Match Officials or Organizers:

Not Applicable

Player: Serious foul play - including the use of excessive or brute force when challenging for the ball

Player: Violent conduct - including elbowing, punching, kicking, running the goalkeeper, or other acts deemed violent (except when against a match official)

Player: Biting or spitting at an opponent or any other person (except when against a match official)

Player: Using offensive, insulting or abusive language and/or gestures (except when against a match official)

Player: Receiving a second caution (yellow card) in the same match

Team Personnel: Delaying the restart of play by the opposing team e.g. holding onto the ball, kicking the ball away, obstructing the movement of a player

Team Personnel: Deliberately leaving the technical area to: show dissent towards, or remonstrate with, a match official; act in a provocative or inflammatory manner

Team Personnel: Enter the opposing technical area in an aggressive or confrontational manner

Team Personnel: Deliberately throwing/kicking an object onto the field of play

Team Personnel: Entering the field of play to: confront a match official (including at half-time and full-time); and interfere with play, an opposing player or a match official

Team Personnel: Physical or aggressive behaviour (including spitting or biting) towards an opposing player, substitute, team official, spectator or any other person (e.g. ball boy/girl, security or competition official etc.) (except when against a match official)

Team Personnel: Receiving a second caution in the same match

Team Personnel: Using offensive, insulting or abusive language and/or gestures (except when against a match official)

Team Personnel: Using unauthorized electronic or communication equipment and/or behaving in an inappropriate manner as the result of using electronic or communication equipment

Team Personnel: Violent conduct

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* 16. MISCONDUCT against MATCH OFFICIALS and ORGANIZERS:

Not Applicable

Using offensive, insulting or abusive language and/or gestures toward a match official or organizer.

Failing to leave the field of play after dismissal, and/or delaying the restart of play due to negative reaction to referee sanctions, and/or refusing to comply with the directives of the match official.

Entering the match official change room/personal space without invitation to engage in discussion in a threatening or unwarranted manner.

Refusal to leave the match official change room/personal space in a timely manner after being dismissed or directed

Assault – attempted deliberate physical contact or deliberate physical contact, or attempted violent conduct or violent conduct (e.g. striking, kicking, spitting, etc.) and/or verbal or physical threats toward a match official or organizer.

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* 17. Disorderliness at Matches and Competitions:

Not Applicable

Inciting hatred and violence during a match (player or organizer)

Inciting hatred and violence (player or organizer) using mass and/or social media or if it takes place on a match day in or around a stadium

Provoking the general public during a match (player or organizer)

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* 18. Team Misconduct:

Not Applicable

Where a referee sanctions at least five (5) members of the same team during a match (caution or expulsion)

Where several players or team personnel of the same team threaten or harass match officials or organizer.

Where two (2) or more players surround a match official to protest a decision.

Un-played match and/or abandonment

Contributing to/participating in a brawl

Inappropriate conduct of a team official(s) resulting in the abandonment of a game.

Zone 4: Lakewood Soccer Association Tournament Misconduct Report

Question Title

* 1. Referee:

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* 2. Game Date

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* 3. Game:

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* 4. Field:

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* 5. Gender:

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* 6. Age Division:

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* 7. Division:

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* 8. Home Team (i.e Lakewood Eagles):

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* 9. Away Team (i.e Aurora Stars):

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* 10. Player:

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* 11. Jersey Number:

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* 12. At the ___________ min of the ___________ half the player was ejected for:

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* 13. Received two (2) Cautions

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* 14. If they received two (2) cautions, what were the cautions for (if applicable)?

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* 15. Serious Infringements of the FIFA Laws of the Game (sending off offenses): Misconduct Against Opponents or Persons other than Match Officials or Organizers:

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* 16. MISCONDUCT against MATCH OFFICIALS and ORGANIZERS:

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* 17. Disorderliness at Matches and Competitions:

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* 18. Team Misconduct:

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* 19. Detailed Description of the Incident:

* 12. At the _ min of the _ half the player was ejected for: