RUGBY FOOTBALL UNION
DISCIPLINE REPORT
PLAYER SENT OFF THE PLAYING ENCLOSURE - SEASON 2016 - 2017
Send to all members of your LSRFUR discipline team as on www.londonrugby.com
Player’s Full Name
Playing Position
Players Club
Date of Dismissal
COMPLETE WHERE APPLICABLE
Type of Match
Comp Title
Video Made?
Video made by
whom?
Team
e.g. 1st XV/ 2nd etc
Level
Match Result
Home Club
pts
Away Club
pts
Nature of Offence – Tick all applicable
10.1
Obstruction
10.2.a
Unfair Play – Intentionally Offending
10.2.b-c
Unfair Play – Time wasting / Throwing into touch
10.4.f
(10.4.e.
4)
10.4.f/
k
10.4.g
10.3
Repeated Infringement
10.4.h
10.4.s/m
Verbal abuse of match official
10.4.i
10.4.s/m
Threatening Actions or Words at Match Officials
10.4.j
10.4.s/m
10.4.a
10.4.a
10.4.a
10.4.a
10.4.b
10.4.c
Physical Abuse of Match Officials
Striking another player with a hand , arm, or fist
Striking another player with the elbow
Striking with the knee
Striking with the head
Stamping/trampling on an opponent
Kicking an opponent
10.4.k
10.4.l
10.4.m
10.4.m
10.4.m
10.4.m
10.4.m
10.4.d
Tripping an opponent with the foot/leg
10.4.m
10.4.e
Dangerous tackling, early / late / including the action
known as the ‘stiff arm’ tackle
Dangerous tackling, including above the line of the
shoulders
Dangerous tackling, tackling an opponent whose feet are
off the ground
Dangerous tackling, including (i) a tackle or attempted
tackle above the line of the shoulders even if the tackle
starts below the line of the shoulders
(ii)grabbing and rolling/twisting around the head/neck
area even if the contact starts below
the line of the shoulders
Incidental Physical Contact with Match Officials
10.4m
10.4.e
10.4.e
10.4.e
10.4.s
10.4.m
10.4.m
10.5.b
10.4.m
Holding pushing or obstructing an opponent not holding the ball,
by a player who is not in possession of the ball, except in a scrum,
ruck, or maul
Dangerous charging or knocking down an opponent without the
ball including shouldering
Dangerous charging or knocking down an opponent with the ball
including shouldering
Charging into a ruck or maul, Charging includes contact without
the use of the arms or without grasping a player
Tackling, tapping, pushing, or pulling an opponent jumping for the
ball in a lineout or open play
Lifting a Player from the ground and either dropping or driving that
player’s head and/or upper body into the ground whilst the
player’s feet are off the ground
Causing a scrum, ruck, or maul to collapse
Retaliation
Testicle grabbing or twisting, or squeezing
Biting
Contact with the eye(s) or the eye area
Spitting at Players
Verbal abuse of Players Match Officials, spectators, coaches or
support staff based on Religion, Race, Colour or National, or Ethnic
Origin, sexual orientation or otherwise.
Any other acts (not previously referred to) which are contrary to
good sportsmanship
Hair pulling or grabbing
Two yellow cards in one match
10.4.n
Totting up of 3 foul play yellow cards within season – applies only
to levels 1-4
Misconduct while ball out of play
10.4.o
Late charging the kicker
Officials
REFEREE
ASSISTANT REFEREE*1
ASSISTANT REFEREE*2
Name
Address
Contact Tel No
Society
* Where applicable
Weather Conditions and State of Pitch
General pattern of play (temper of game) and details of any injuries sustained to person(s) involved with the incident.
OFFICIALS DETAILED REPORT OF INCIDENT
Proximity of Ref/TJ to offence
metres
Time of Incident
mins
View of incident obstructed
FH/SH/ET
Y/N
Score at time
H
A
Cautions Issued:
This Player
Other Players Individually
General
Notes on the incident
(Include detailed description of the incident, force of any punch, any injury incurred, any medical attention needed, any apology received.)
REFEREE (digital signature acceptable):
EMAIL:
DATE:
LSRFUR Red Card Form, Updated January 2017