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Report an Incident
Report a Black Card Incident
*
Indicates required field
Referee Name
*
First
Last
Match Details (Teams and Grade)
*
As per your appointments
Was the person identified?
*
Yes (Team Official)
Yes (Spectator)
No
Which Club/Team?
*
Specify the Club and Team the person is associated with (if known)?
Description of incident
*
Provide as much detail as possible. You must specifically describe the actions and language used during the incident (including specific swear words, etc.). Was a Ground Marshall/TSM called and what actions were taken?
Submit
