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Dismissal Form

Home » Referees » Dismissal Form

Dismissal Formaccounts@newfoundmarketing.ca2025-06-03T11:59:52-03:00

DISMISSAL FORM (#37)

SOCCER NOVA SCOTIA DISMISSAL FORM

GAME DETAILS

The Referee must submit this report within 24 hours of the game.

Season:

Competition/League:

Game Date:

Game Time:

Field:

Age Group:

Gender

Division:

Home Team

Visiting Team

Person Dismissed:

Person Dismissed from:

Home Team

Visiting Team

Person was a:

Player

Team Staff/Coach

First Name

Last Name

INCIDENT DETAILS

RED CARD (Team Staff):

delaying the restart of play by the opposing team. e.g. holding onto the ball, kicking the ball away, obstructing the movement of a player

deliberately leaving the technical area to: show dissent or remonstrate with a match official or act in a provocative or inflammatory manner

enter the opposing technical area in an aggressive or confrontational manner

entering the field of play to: confront a match official (including at half-time and full-time), or interfere with play, an opponent or match official

physical or aggressive behaviour (including spitting or biting) towards an opposing player, substitute, team official, match official, spectator or any other person (e.g. ball boy/girl, security or competition official etc.)

receiving a second caution in the same match

using offensive, insulting or abusive language and/or gestures

using unauthorized electronic or communication equipment and/or behaving in an inappropriate manner as the result of using electronic or communication equipment

violent conduct

RED CARD (Player):

denying the opposing team a goal or obvious goal-scoring opportunity by a handball offence

denying a goal or an obvious goal-scoring opportunity to an opponent whose overall movement is towards the offender’s goal by an offence punishable by a free kick (except where a PK was given and challenge was attempt to play ball)

serious foul play

biting or spitting at someone

violent conduct

used offensive or insulting or abusive language and/or gestures

dismissal for a second caution - one (or more) was for dissent

dismissal for a second caution - no caution was for dissent

Misconduct was directed at a match official:

Yes

Minute the incident occurred.

DESCRIPTION OF INCIDENT

Please provide the description of the incident.

Description of the incident:

Is there a Special Incident report that accompanies this dismissal Report?

Yes

REFEREE DETAILS

Referee

First Name

Last Name

4th Official (if assigned)

First Name

Last Name

Assistant Referee #1

First Name

Last Name

Assistant Referee #2

First Name

Last Name

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