Michigan’s
Champions League
Referee
Game Report.
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GAME: |
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Home Team |
Score |
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Visiting Team |
Score |
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Date of Game: |
Scheduled time: |
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Field and Address: |
Actual kick off: |
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End of game: |
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Score at half time: |
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REFEREE: |
Grade: |
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Assistant: |
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Grade: |
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SSN: |
- - |
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Assistant: |
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Grade: |
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SSN: |
- - |
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Field Condition: |
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Weather: |
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YES |
NO |
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Players Passes of the visiting team were received and checked. |
YES |
NO |
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YES |
NO |
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Line-up of visiting team is enclosed. |
YES |
NO |
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Serious injuries during the game.
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Name |
Pass No. |
Team |
Nature of Injury |
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Players cautioned during the game.
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Name |
Pass No. |
Team |
Type of Misconduct |
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Players sent off the field—Player passes must be retained after the game and returned to proper authority with this report.
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Name |
Pass No. |
Team |
Type of Misconduct |
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Referee Signature: |
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Phone #: |
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Home Signature |
Visitor Signature |
Date: |
FEE SCHEDULE
u9/u10 (6v6) $32 (Center Only)
u9/u10 (8v8) $28 (Center), $18 (Assistant #1), & $18 (Assistant #2)
u11/u12 (8v8) $30 (Center), $20 (Assistant #1), & $20 (Assistant #2)
u11/u12 (11v11) $34 (Center), $20 (Assistant #1), & $20 (Assistant #2)
u13/u14 (11v11) $34 (Center), $25 (Assistant #1), & $25 (Assistant #2)
High School JV or Varsity (11v11) $40 (Center), $30 (Assistant #1), & $30 (Assistant #2)
Teams split all referee fees and will present payment during the check-in procedure.
Teams should pay for referees if they are present. Club linesmen under no circumstance should be paid.
Please mail game report to Champions League 6757 Cascade Rd SE #56, Grand Rapids, MI 49546 no later than 48 hours after the game.