NYSRRS Card Reporting Form

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NYSRRS Card Reporting Form

Please submit one response for each offense; if there were multiple cards in a match, create a separate report for each one

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* Indicates required question

Referee Name *

Your answer

Option 1

Clear selection

Referee Email *

Your answer

Referee Phone Number *

Your answer

Date of Match *

MM

/

DD

/

YYYY

Offense *

Red

Yellow

Off Field Misconduct

Offending Team *

Your answer

Offending Player's Name (contact team rep if you have to- we need the name) *

Your answer

Offending Player's Number *

Your answer

Minute of Match *

Your answer

Description of Offense *

Your answer

Law Number *

Your answer

Aggravating Factors

Your answer

Mitigating Factors

Your answer

Submit

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