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General
Your Name:
Your RoleIf Other:
Organization/Conference:If Other:
Sport:
I am associated with the
Email:
Phone:



Game Administration
Game Date:
Game Time:
Game Location/Field:
Game Level: If Other:
Name of Home Team:
Name of Visiting Team:
Locker Facilities:
Security:
Field & Table Setup:
Ball Handling:
Home Team Conduct:
Home Coach Conduct:
Visiting Team Conduct:
Visiting Coach Conduct:



Game Expulsion
Was a player, coach or fan expelled? If other:
If a player was ejected then we need this information.
Team:
Player Jersey #:
Quarter:
Time in that quarter:
Number of minutes:
Reason:
If a coach or spectator was ejected then we need this information.
Team:
Quarter:
Time in that quarter:
Number of minutes:
Reason:


Incident Details:
Additional Comments:







Slashing #5 (slow motion)










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