Send off Report 2009
To be sent within 24 hours to your sub-union VP Discipline.  ERU: Mike Dowell at mike@austinsecurity.ca
with a COPY to Rugby Alberta at rugbyab@telus.net

Rugby Alberta Match Officials Association

Referee’s Send-off Report

Match:                                                   vs.

Division:                        Venue:                                     Date:

Time:  1^st half / 2^nd half                  Time elapsed:      5  10  15  20  25  30  35  40

Score at time of incident:                               Final score:

The incident occurred at:                               Scrum              Line-out           Tackle

                                                                        Ruck                Maul                General play

Position of the incident on the field:

Referee’s position relative to the incident:

Referee’s view of the incident:

Position of the ball in relation to the incident:

The incident was:       Minor               Severe              Dangerous             Violent

Were other players sin-binned or sent off in relation to the incident?

Cautions:                    Had a previous caution been issued?                       Yes / No

                                    If so, was it                                                              Individual / Team

                                    Had the player sent off been warned earlier?        Yes / No

                                    Had the player sent off been sin-binned earlier?   Yes / No

Did you observe anything which may have provoked the incident?

Player’s reaction to the sending off:

Did any incidents occur after the sending off which related to the incident?

Details of injuries relating to this incident:

Did the incident cause any opposition player to have medical treatment on the field or to leave the field for treatment?

Assistant Referee’s report:

Was the sending off based on a report from an Assistant Referee?                     Yes / No

If yes, name of the Assistant Referee submitting additional report (Law 6.B.7)

Player’s full name:                                         Team:

Position:                                                                     Number:

Incident description (Including Laws under which recommendation was made to send player off):

(Use additional space, if required)

Submitted by:

Print name:                                                   Signature:

Contact details:                                            Date:

This Report must be completed and submitted to the Designated Union or Disciplinary Official within 24 hours.  In some instances it will be essential to submit immediately after the match.