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Div 1/2 Voting Form
ACT Rugby Union
Send Off Report
Due by 10.00am the Monday following the match
Indicates required field
Details of player Sent Off (Red Card)
Please enter the date in the form dd/mm/yyyy.
Division / Grade
- select -
Premier 1st Grade
Premier 2nd Grade
1st Division 1st Grade
1st Division 2nd Grade
Score at time of incident
Fine and Sunny
Overcast and Dry
Cold and clear
Cold and Foggy
Select the description that best describes weather conditions on the day.
Select the description that best describes the playing surface.
Tone of the Match
Describe the general tone of the game.
- select -
10.2 (a) Intentional Offending
10.3 (a) Repeated Infringements
10.4 (s) (m) Dissent towards Match Official
10.4 (s) (m) Verbal Abuse of Match Official
10.4 (s) (m) Threatening Actions or Words at Match Official
10.4 (s) (m) Physical Abuse of Match Official
10.4 (s) (m) Incidental Physical Contact with Match Official
10.4 (a) Striking another Player with Elbow, Knee or Head
10.4 (a) Striking another Player
10.4 (b) Stamping / Trampling on an Opponent
10.4 (c) Kicking an Opponent
10.4 (d) Tripping an Opponent with the foot / leg
10.4 (e) Dangerous Tackle (early / late / shoulder charge / stiff arm)
10.4 (e) Dangerous Tackle (above line of shoulders / grabbing and rolling, twisting around the head and neck area)
10.4 (f) Holding, pushing or obstructing an Opponent
10.4 (g) 'Dangerous' Charging or Obstruction or grabbing of an Opponent
10.4 (h) Charging into a ruck or maul
10.4 (i) Tackling, pushing, pulling, colliding with or otherwise making contact with an Opponent jumping for the ball in lineout or open play
10.4 (j) Lifting a player from the ground and either dropping or driving player's head and/or upper body into ground
10.4 (k) Causing a scrum, ruck or maul to collapse
10.4 (m) Grabbing, twisting, squeezing or striking an Opponents genital area (including female breast area)
10.4 (m) Biting
10.4 (m) Contact with the eye/s or eye area
10.4 (m) Spitting at Players
10.4 (m) Verbal abuse of players, spectators, coaches or support staff based on religion, race, colour, national or ethnic origin or sexual orientation
10.4 (m) Any other acts which are contrary to good sportsmanship
10.4 (m) Hair pulling or grabbing
10.4 (o) Late charging the kicker
10.5 (b) 2nd Yellow Card Offence
When did the Red Card incident occur?
Approximate Time of Offence
Where on the field did the offence take place
For 2nd Yellow Card Offence
What offence was the 1st Yellow Card issued?
What offence was the 2nd Yellow Card issued?
Straight Send Off Offence
The Send-off Offence was:
Careless / Reckless
Intentional / Deliberate
How would you grade the send-off/red card offence?
The offence occured at:
Out of Play
What phase of play did the red card offence take place?
Please describe the circumstances of the offence(s) in as much detail as relevant.
Please provide accurate detail describing the red card offence. Include sufficient detail so that the judiciary can get a precise and clear picture of what had occured which gave you cause to send the player from the field. (eg points of contact to the body, number of times, vulnerability of players etc)
Where were you in relation to the incident?
Distance from the offence? Did you have a clear line of sight or was your vision obstructed?
Player reaction after being sent off:
How did the player being sent off and the team captan react to the red card?
Captain reaction after being sent off?
Match Official details:
Match Officials Name
If the send off was based on advice from an Assistant Referee, the Assistant Referee must complete the send off reporting form
Submit / Send