EJECTION / INCIDENT REPORT

 

NAME OF SPORT:____________________ DATE OF GAME:_____________________

LEVEL:            V   JV    F/S   (Circle one)     Boys (  )   Girls (  )

VISITING SCHOOL:__________________        HOME SCHOOL:_____________________

POSITION YOU WERE  WORKING:_______    PARTNER’S NAME:__________________

SCORE AT TIME  OF EJECTION:  VISITORS ______  HOME ____

WHEN EJECTION TOOK PLACE: ______                                                           

FINAL SCORE: VISITORS ________         HOW LONG WAS                 HOME______                                      GAME DELAYED:__________

NAME AND SCHOOL OF PERSON EJECTED:_____________________________________

                                                    (If coach, indicate Head or Asst.)

____________________________________________________________________________

 WHAT LED TO THE EJECTION

(Circle when applicable)           

RULING:               BOOK            CIF-SS RULE                JUDGMENT 

                                 REASON FOR THE EJECTION

LANGUAGE:      PROFANITY    ABUSIVE      PERSONAL       HECKLING

PHYSICAL CONTACT:     BUMPING  PUSHING  STRIKING    FIGHTING   KICKING 

ACTION WAS AGAINST:     UMPIRE    OPPONENT    SPECTATOR     TEAMMATE

Briefly Describe Incident

____________________________________________________________________________ 

Had the ejected person been warned before:         Yes      No    (circle)

 

_______________________    _______________________          ______________________

Print Your Name                              Work Phone Number                      Home Phone Number