ࡱ> ikhq  bjbjt+t+ "VAAX ]\lg^^^^^8 , $Z ^^Z Z ^^Z ^^Z ^nӂ8  UNITED STATES SOCCER FEDERATION REFEREE REPORT This report must be mailed within 48 hours after completion of game to proper authorities. GAME: FORMTEXT       FORMTEXT    FORMTEXT       FORMTEXT   Home TeamScorevs.Visiting TeamScore State Association/Division/Professional League FORMTEXT      Age Group FORMTEXT       Date of Game: FORMTEXT       Scheduled time: FORMTEXT      Field and Address: FORMTEXT       Actual kick off: FORMTEXT       FORMTEXT       End of game: FORMTEXT       FORMTEXT       Score at half time: FORMTEXT       REFEREE: FORMTEXT      Grade:  FORMTEXT  SSN: FORMTEXT      Sr. Assistant: FORMTEXT      Grade:  FORMTEXT  SSN: FORMTEXT      Jr. Assistant: FORMTEXT      Grade:  FORMTEXT  SSN: FORMTEXT      4th Official: FORMTEXT      Grade:  FORMTEXT  SSN: FORMTEXT       Field Condition: FORMTEXT      Weather: FORMTEXT      Was the home team on the field on time? FORMDROPDOWN If not, how late? FORMTEXT      No. of Spectators:  FORMTEXT       approx.Was the visiting team on the field on time? FORMDROPDOWN If not, how late? FORMTEXT      Marking of field:  FORMDROPDOWN Players Passes of the home team  FORMDROPDOWN  received and checked.Conduct of Officials: FORMDROPDOWN  Players Passes of the visiting team  FORMDROPDOWN  received and checked.of Players: FORMDROPDOWN Line-up of home team  FORMDROPDOWN of Spectators: FORMDROPDOWN Line-up of visiting team  FORMDROPDOWN Dressing room for Referee: FORMDROPDOWN 4th Official Game Log  FORMDROPDOWN for Players: FORMDROPDOWN A supplementary form explaining circumstances must accompany any unusual situations. Serious injuries during the game. NamePass No.TeamNature of Injury FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       Players cautioned during the game. NamePass No.TeamType of Misconduct FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  Players sent off the field Player passes must be retained after the game and returned to proper authority with this report. NamePass No.TeamType of Misconduct FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  I  FORMDROPDOWN  the referee fee of $  FORMTEXT    .Referee Signature: FORMTEXT      Phone #:( FORMTEXT    )  FORMTEXT       For additional remarks use supplementary sheet.Date: FORMTEXT      For serious assault, severe injury, or other substantial occurrences, a photo copy must be sent to Federation Headquarters: Fax: (312) 808-9572 Distribution: State Association / League / Referee Apr02 Hf $02FHJTVXZnprvx|~DFZ^   "$.0jo Uj Uj U5CJ5CJjA UjUjU jUmHj$U6CJ5CJ5CJ5 jUAHj"$0Xz|$$$$&#$f)/+D @ &#$f)/+D H&#$f)/+D  &d  &#$ / Hj"$0JTXrvz|DFZ\^ $.2Vpz~ "$>HLj       . 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