Incident Report Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.GAME OFFICIALSReferee 1 - Official Submitting Report *FirstLastReferee 2 (if applicable)FirstLastLinesperson 1 *FirstLastLinesperson 2 *FirstLastGAME DETAILSDate *Type of Game *LeaguePlayoffExhibitionProvincialTournamentArena *Home Team *Visiting Team *INCIDENT DETAILSName of Offender *FirstLastPlayer or Team OfficialPlayerTeam OfficialJersey Number *Role of Team Official *Head CoachAssistant CoachTrainerManagerOffending Team *HomeVisitorWhen infraction occurred *1st Period2nd Period3rd PeriodOTPre-GamePost-GameTime of Infraction (enter N/A if pre- or post-game) *Are there other reports being submitted related to this incident? *YesNoIf Yes, how many other reports? * Official Are Section Was there an injury? *YesNoStatus of injured player *Stayed in gameLeft, but returnedLeft, did not returnRULE VIOLATEDSection *7.1b Major + GM Grabbing Hair, Face Protector, Chin Strap, Helmet, Throat Protector7.1c Match Headbutt, Grab Hair/ Facial Protector, Kicking, or Use Helmet/Equipment as Weapon7.2 Boarding/Bodychecking7.3 Bodychecking7.4 Charging7.5 Checking from Behind7.6 Head Contact7.8 Kneeing7.9 Roughing7.10 Fighting7.11 Instigator/ Aggressor8.1 Holding8.2 Hooking8.3 Interference8.4 Interference from Bench8.5 Interference with Goaltender8.6 Tripping8.7 Clipping8.8 Slewfooting9.1 Butt Ending9.2 Crosschecking9.3 Slashing9.4 Spearing10.4 Leaving Player/Penalty Bench10.5 Throwing or Shooting Stick or Object10.8 Refusing to Start Play11.1 Unsportsmanlike Conduct11.2 Disrespectful, Abusive, Harassing Behaviour11.3 Spitting11.4 Discrimination11.5 Physical Harassment of OfficialsOtherSubsection - Include the Rule Subsection violated or more details if you checked OtherDid the incident include an Allegation of Discrimination?NoYesINCIDENT DESCRIPTION Provide all relevant information pertaining to the incident:Details of Incident *Submit Report
