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Competition
Home Team
Away Team
Venue
Date
Time
Players Name & No
Caution Offence
Select One
N/A
Y1 Unsporting Behaviour - Late tackle
Y2 Unsporting Behaviour - Reckless tackle
Y3 Unsporting Behaviour - Foul tackle from behind
Y4 Unsporting Behaviour - Deliberate and blatant tripping
Y5 Unsporting Behaviour - Deliberate and blatant handball
Y6 Unsporting Behaviour - Blatant holding an opponent
Y7 Unsporting Behaviour - Heavy body charge
Y8 Unsporting Behaviour - Jumping at an opponent
Y9 Unsporting Behaviour - Pushing an opponent
Y10 Unsporting Behaviour - Elbowing an opponent
Y11 Unsporting Behaviour – Breaking up a promising opposition attack
Y12 Encroachment when play is restarted with a free kick corner kick or throw-in
Y13 Shows dissent by word
Y14 Shows dissent by gesture
Y15 Persistently infringing the Laws of the Game
Y16 Delaying the restart of play
Y17 Making unsporting remarks or gestures
Y18 Entering the field of play without the referee’s permission
Y19 Leaving the field of play without the referee’s permission
Y20 Unsporting Behaviour - Blatant diving
Y21 Unsporting Behaviour - Feigning injury
Y22 Removing the shirt to celebrate scoring a goal
Y23 Conduct warranting a caution not previously specified
Y24 Unsporting behaviour by a substitute
Y25 Dissent by a substitute
Y26 Delaying the restart of play by a substitute
Y27 Provoking a confrontation by deliberately touching the ball after
Players Club
SECOND CAUTION OFFENCES ONLY
Time2
2nd Caution Offence
N/A
Y1 Unsporting Behaviour - Late tackle
Y2 Unsporting Behaviour - Reckless tackle
Y3 Unsporting Behaviour - Foul tackle from behind
Y4 Unsporting Behaviour - Deliberate and blatant tripping
Y5 Unsporting Behaviour - Deliberate and blatant handball
Y6 Unsporting Behaviour - Blatant holding an opponent
Y7 Unsporting Behaviour - Heavy body charge
Y8 Unsporting Behaviour - Jumping at an opponent
Y9 Unsporting Behaviour - Pushing an opponent
Y10 Unsporting Behaviour - Elbowing an opponent
Y11 Unsporting Behaviour – Breaking up a promising opposition attack
Y12 Encroachment when play is restarted with a free kick corner kick or throw-in
Y13 Shows dissent by word
Y14 Shows dissent by gesture
Y15 Persistently infringing the Laws of the Game
Y16 Delaying the restart of play
Y17 Making unsporting remarks or gestures
Y18 Entering the field of play without the referee’s permission
Y19 Leaving the field of play without the referee’s permission
Y20 Unsporting Behaviour - Blatant diving
Y21 Unsporting Behaviour - Feigning injury
Y22 Removing the shirt to celebrate scoring a goal
Y23 Conduct warranting a caution not previously specified
Y24 Unsporting behaviour by a substitute
Y25 Dissent by a substitute
Y26 Delaying the restart of play by a substitute
Y27 Provoking a confrontation by deliberately touching the ball after
SEND OFF OFFENCES
Time
Send Off Offence
Select One
N/A
R1 Serious Foul Play - Striking an opponent
R2 Serious Foul Play - Kicking an opponent
R3 Serious Foul Play - Elbowing an opponent
R4 Spitting at an opponent
R5 Law 12 Offence Denying an obvious goal scoring pportunity
R6 Handball Offence Denying an obvious goal or goal scoring opportunity
R7 Serious Foul Play - A tackle which endangers the safety of an opponent
R8 Offensive insulting abusive language
R9 Offensive insulting abusive gestures
R10 Second caution
R11 Behaving in an irresponsible manner
R12 Violent Conduct
R13 Commits a sending off offence having been sent off
R14 Offensive insulting abusive language and/or gestures against a match official
R15 Violent Conduct – Assault of a Match Official
R16 Send-off not previously specified
Explanation
Referee Name
Referee Number
Email Address
TO BE COMPLETED BY NELSON BAYS FOOTBALL
a) Suspension days this offence
b) Exceptional Misconduct
Judiciary Officer’s Comments
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