League * Select LeagueSouth East KootenaysThompson OkanaganLower MainlandVancouver IslandGreat White North

Division *

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GAME OFFICIALS

Official Calling the Penalty

Name *

Phone *

Email *

Second Official

Name

Phone

GAME OFFICIATED

Date of Game

Game Level

Venue of Game

Game Start Time

TEAMS

Home Team

Home Team Coach

Visiting Team

Visiting Team Coach

GAME TYPE *

Game Type *

League

Playoff

Exhibition

Championship

Tournament

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PENALTY TYPE * Please Select... Other Minor Major Game Misconduct Gross Misconduct Match Penalty

PENALTY ASSESSED * Please Select... Other 3rd man in Aggressor Boarding Butt Ending Charging Check from behind Cross Checking Elbowing Fighting High Sticking Instigator Interference Kicking Kneeing Official Abuse Slashing Spearing Unnecessary Roughness Unsportsmanlike

Team penalized

Player/Coach penalized

Jersey Number

Period of Penalty

Time of Penalty

Describe circumstances in detail

After you press the submit button this report will be emailed to the members of the Commission selected above. A copy will also be sent to your email address.

Clear

This infraction must be immediately telephoned to the Minor Association Head Referee. It is the duty of the Head Referee to notify the League Commissioner within 24 hours of the game.

Infractions of a serious nature, including all incidents of Abuse of Officials or GROSS Misconduct must be reported to the BCLOA Vice-Chair Minor/Senior.

This report contains confidential information. Copies shall only be distributed to authorized persons