Sample CYSA Send-off Report for Serious Foul Play

CALIFORNIA YOUTH SOCCER ASSOCIATION
REFEREE'S SEND-OFF REPORT
Game Date:10/30/00
Field: Grassy Knoll
City: Dreamland
League: East Contra YSL
Age Group: U16G
Game Time: 2:00 p.m.
Home Team: Goodie Too Shoes
Visiting Team: Poor Sports
Name of Individual: Vicky Violencia Time of Foul: 18th Minute, First Half
Registration # 0018-0000
Individual Sent Off Was:
Jersey # 6
⌧
Team: Poor Sports
PLAYER
COACH
INDIVIDUAL WAS SENT OFF FOR:
⌧
SERIOUS FOUL PLAY
VIOLENT CONDUCT
SPIT AT OPPONENT OR ANY OTHER PERSON
DENIED OBVIOUS GOAL-SCORING OPPORTUNITY BY DELIBERATELY
HANDLING BALL
DENIED OBVIOUS GOAL-SCORING OPPORTUNITY'TO OPPONENT MOVING
TOWARDS GOAL BY OFFENSE PUNISHABLE WITH FREE KICK OR PENALTY
KICK
OFFENSIVE, INSULTING OR ABUSIVE LANGUAGE
SPECIFIC LANGUAGE OR GESTURE:
DIRECTED AT:
OPPONENT
REFEREE
TEAMMATE
COACH
SELF
OTHER:
RECEIVED SECOND CAUTION IN SAME GAME
EXPLANATION: In the 18th minute of the first half, Poor Sports No. 6, Vicky Violencia (CYSA 00180000) committed a foul using excessive force by sliding into a Goodie Too Shoes striker going over the
ball with cleats exposed making contact with the Goodie Too Shoes player in the upper thigh. The referee
immediately stopped play, called the Goodie Too Shoes trainer onto the field, and then sent off and
showed the red card to Ms. Violencia. Before leaving the field, Ms. Violencia used (cont’d)
(use back for more space)
Referee: John F. Whistleblower
Asst. Referee 1: Red E. Flagger
Asst. Referee 2: Oph S. Watcher
Phone: (925) 525-1212
Phone: (510) 525-1212
Phone: (510) 525-1234
CALIFORNIA YOUTH SOCCER ASSOCIATION
REFEREE'S SEND-OFF REPORT
EXPLANATION CONTINUED:
Offensive, Abusive or Insulting language by loudly shouting: “Referee, you suck. You are a damn pinhead.
You’re a cheat for the other team.” Ms. Violencia then left the field, picked up an equipment bag and threw
it onto the field. At that point the Poor Sports coaching staff was able to calm down Ms. Violentia. The
referee then restarted the match without further incident by Ms. Violencia.
EDITOR’S NOTE:
1. The sent-off player committed additional acts of misconduct.
Those incidents are included in the Send-off Report, but that
player does NOT receive an additional send-off, and the red
card is not displayed a second time.
2. When Offensive, Abusive or Insulting language (AL) is
recorded, the exact language used must be spelled out, no
matter how offensive or odious it is for the referee to do so.
If the report contains AL, then a cover sheet can be used to
warn readers.
DISCIPLINARY COMMITTEE ACTION
Suspension:
Games
Games Served:
Other Penalties:
Official
Position
Date