Whatcom County Adult Soccer Association
PO Box 29716, Bellingham WA 98228
MISCONDUCT REPORT
Please complete the form below. Refer to USSF Referee Administrative Handbook for sections entitled
“Procedure: Guide Report Writing” and “Summary of Report Writing Procedures” for assistance in completing
this report. Drop the game report and the players WSSA Player card in the WCASA Box at NWSP ASAP. If
playing at WCC Field advise: Lindsay Spencer/Referee Assignor by phone at (360) 305-0138 or email ASAP.
Complete this report & return to [email protected] within 24 hours.
Referee Information
Name
Daytime Phone #
Game Date
Evening Phone #
Game Information
Home Team Name
Opposing Team Name
Offending Player Information
Players Name
Team Name
SEND OFF (please circle or highlight reason for ejection)
 Serious foul play
 Violent conduct
 Spitting at an opponent or any other person
 Denies a goal by deliberate hand ball
 Denies obvious goal scoring opportunity by an offense punishable by free kick
 Offensive, insulting or abusive language and/or gestures
 Second cautionable offense
Explanation of Incident (use back of sheet or additional pages as needed)