BRITISH COLUMBIA
SOCCER ASSOCIATION
#510 - 375 Water Street, Vancouver, V6B 5C6
• Tel: (604) 299-6401 • Fax: (604) 299-9610
FORWARD TO APPROPRIATE AFFILIATE
VISL (div 6) • Scott Metson • Fax: 598-0889 • vladtheimpaler13@shaw.ca
VISL (div 1-5) • Vince Greco • Fax: 360-1648 • vincentgreco@shaw.ca
UISA • Kevin Cowie • Fax: 923-7923 • kc_owie@oberon.ark.com
MIWSL • Stu Power • Tel: 339-6256 • visranorth@shaw.ca
REFEREE’S REPORT REGARDING
MISCONDUCT
Send to: Secretary of the Disciplinary Committee
not later than 24 hours after the game.
Referee’s Name___________________________ : ____________________________Date of Game
Home Team_______________________________vs______________________________Away Team
Venue___________________________________ : ______________________________Competition
Arising from this game (check one offence) I have to report that I SENT OFF FOR:
O Violent conduct *
O Serious foul play
O Spitting at an
opponent (or at any other person)
O Receiving a second
caution in the match
O Offensive, insulting
or abusive language
O Deliberately handling
the ball to deny a goal (not goalkeeper in own penalty area)
O Committing an offence
to deny a goal or obvious goalscoring opportunity
(any offence punishable by a free kick or penalty kick)
Player Name_________________________ Number ______ of the _______________________Team
The incident which came to my attention was as follows:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Signature___________________Phone____________Email___________________________________________
Address___________________________________________________________________________________
* Assaults on Game Officials
should be reported to the Secretary of the B. C. Soccer
Association
Contact should also be made with your area
President and the President of the BCSA