CMSA Game Report

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Central Michigan Soccer Association

Game Report & Team Roster (Please type or print clearly)

Age Group U- ________ Boys { Girls { Division: _____________


Game Date: __________ Game Time: _______ CMSA Game #: _____

Field Location: _______________________________________________________________________________

Home Team: ______________________________________ The roster below is for the Home { Away { Team
Team Color is:__________________________
Visiting Team: ______________________________________
Misconduct
Reason for Uniform Caution Send Off Indicate appropriate
Present Absent
Sitting Out # Player and Coach Full Names Goals
(Yellow) (Red) Misconduct number below:
Cautionary Offenses
(Yellow Card)
1. Is guilty of unsporting behavior
2. Shows dissent by words or
action
3. Persistently infringes the laws
of the Game
4. Delays the restart of play
5. Fails to respect the required
distance when play is restarted
with a corner kick or free kick.
6. Enters or reenters the field of
play without referee’s permission
7. Deliberately leaves the field of
play without referee’s permission.
Send-Off (Red Card)
A. Is guilty of serious foul play.
B. Is guilty of violent conduct
C. Spits at an opponent or any
other person
D. Uses offensive, insulting or
abusing language.
E. Denies an opponent a goal or
an obvious scoring opportunity by
deliberately handling the ball.
F. Denies an obvious goal scoring
opportunity to an opponent
moving toward the player’s goal
by an offense punishable by a free
kick or penalty kick.
G. Receives a second caution in
the same match.
Send-Off Offenses must be
Head Coach: explained on the back of the
form.
Asst. Coach: All Send-Off’s receive:
#A-D (2 game suspension)
Manager: #E-G (1 game suspension)

(Please print clearly) Fair Play (Poor) 1 2 3 4 5 (High)


Referee: Players { { { { {
Asst. Referee: Coaches { { { { {
Asst. Referee: Parents /Fans { { { { {
(Complete this section after the game) Home Team Official’s Signature Visiting Team Official’s Signature
Protested Game? ____ Yes
____ No
By which Team? ____ Home
____ Away Home Team Goals: Visiting Team Goals:
[Winning team (home team if tie) coach is required to send completed Game Report to appropriate CMSA VP. Game report must be
received within 7 days of game date or responsible team will forfeit match] Revised 07/05/06

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