Send Off Report
Name of player sent off :
Player’s number:
Player’s club:
Send-off date:
Match between:
Grade:
Score:(Home Team)(Visitors)
Time into match offence occurred :
Ground & weather conditions :
Where did the offence occur on the field?
Where were you in relation to the offence?
Player’s reaction after being sent off:
SEND OFF DUE TO 2 x YELLOW CARDS – leave this section blank if send off is not 2 x YC
For what offence was the 1st Yellow Card issued? Law 10.1 Obstruction (any) Law 10.2(a) Intentionally offending Law 10.2(c) Throwing into touch Law 10.4(a) Punching or striking Law 10.4(b) Stamping or trampling Law 10.4(c) Kicking Law 10.4(d) Tripping Law 10.4(e) Dangerous tackling Law 10.4(f) Playing an opponent without the ball Law 10.4(g) Dangerous charging Law 10.4(h) Charging into a ruck or maul Law 10.4(i) Tackling a jumper in the air Law 10.4(j) Lifting tackle Law 10.4(k) Dangerous play in scrum, ruck or maul Law 10.4(l) Retaliation Law 10.4(m) Acts contrary to good sportsmanship Law 10.4(n) Misconduct while ball is out of play Law 10.4(o) Late-charging the kicker Law 10.4(p) Flying Wedge and Cavalry Charge Law 10.4(s) Dissent and/orLaw 10.3(a) Repeatedly offending (individual) Law 10.3(b) Repeated infringements by the team
For what offence was the 2nd Yellow Card issued? Law 10.1 Obstruction (any) Law 10.2(a) Intentionally offending Law 10.2(c) Throwing into touch Law 10.4(a) Punching or striking Law 10.4(b) Stamping or trampling Law 10.4(c) Kicking Law 10.4(d) Tripping Law 10.4(e) Dangerous tackling Law 10.4(f) Playing an opponent without the ball Law 10.4(g) Dangerous charging Law 10.4(h) Charging into a ruck or maul Law 10.4(i) Tackling a jumper in the air Law 10.4(j) Lifting tackle Law 10.4(k) Dangerous play in scrum, ruck or maul Law 10.4(l) Retaliation Law 10.4(m) Acts contrary to good sportsmanship Law 10.4(n) Misconduct while ball is out of play Law 10.4(o) Late-charging the kicker Law 10.4(p) Flying Wedge and Cavalry Charge Law 10.4(s) Dissent and/orLaw 10.3(a) Repeatedly offending (individual) Law 10.3(b) Repeated infringements by the team
STRAIGHT SEND OFF OFFENCE – leave this section blank if send off is 2 x YC
Had the player been previously warned or yellow carded during the game? No Warning/admonishment Yellow Card Both warning and Yellow Card
If yes – please state the warning and/or describe the yellow card :
For what offence was the red card issued? Law 10.1 Obstruction (any) Law 10.2(a) Intentionally offending Law 10.2(c) Throwing into touch Law 10.4(a) Punching or striking Law 10.4(b) Stamping or trampling Law 10.4(c) Kicking Law 10.4(d) Tripping Law 10.4(e) Dangerous tackling Law 10.4(f) Playing an opponent without the ball Law 10.4(g) Dangerous charging Law 10.4(h) Charging into a ruck or maul Law 10.4(i) Tackling a jumper in the air Law 10.4(j) Lifting tackle Law 10.4(k) Dangerous play in scrum, ruck or maul Law 10.4(l) Retaliation Law 10.4(m) Acts contrary to good sportsmanship Law 10.4(n) Misconduct while ball is out of play Law 10.4(o) Late-charging the kicker Law 10.4(p) Flying Wedge and Cavalry Charge Law 10.4(s) Dissent and/orLaw 10.3(a) Repeatedly offending (individual) Law 10.3(b) Repeated infringements by the team and (if 2 x offences) Law 10.1 Obstruction (any) Law 10.2(a) Intentionally offending Law 10.2(c) Throwing into touch Law 10.4(a) Punching or striking Law 10.4(b) Stamping or trampling Law 10.4(c) Kicking Law 10.4(d) Tripping Law 10.4(e) Dangerous tackling Law 10.4(f) Playing an opponent without the ball Law 10.4(g) Dangerous charging Law 10.4(h) Charging into a ruck or maul Law 10.4(i) Tackling a jumper in the air Law 10.4(j) Lifting tackle Law 10.4(k) Dangerous play in scrum, ruck or maul Law 10.4(l) Retaliation Law 10.4(m) Acts contrary to good sportsmanship Law 10.4(n) Misconduct while ball is out of play Law 10.4(o) Late-charging the kicker Law 10.4(p) Flying Wedge and Cavalry Charge Law 10.4(s) Dissent
The offence was:Careless/Reckless Intentional
The scale of seriousness of the player’s conduct was: Low End Mid Range Top End
Description of offence/s. As a minimum, include brief context (pre & post events), exact language used if dissent, whether an Assistant Referee was consulted, and for dangerous play if relevant indicate part of the body used by offender and part of victim’s body involved/affected.
Referee’s Name: