PH: 604/525-8481/FAX: 604/525-8684

bmsa@shaw.ca

OFFICIATING REPORT

Manager: Please Complete:

SCORE: ________________ VISITOR: _______________ WEEK #: ____________

TEAM NAME: ______________________ ________________________

Home Away

Field: ________________________ Date: ______________ Time: ____________________

Game Official [s] performed the following duty [ies]:

Check condition of field: …………………………………….. Y: ___ N: ___

Check for Corner Flags: ……………………………………… Y: ___ N: ___

Check that the nets were properly installed: …………………. Y: ___ N: ___

Check Player I.D. Cards: …………………………………….. Y: ___ N: ___

Check players for Shin Guards: ……………………………… Y: ___ N: ___

Produce Flags to run the line: ………………………………… Y: ___ N: ___

Check that orange centerline pylons were in place: …………. Y: ___ N: ___

GENERAL COMMENTS:

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[Use back of page if more space is required]

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Signature of Official Team Representative