Game Day Player Safety Reporting Form

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This form is for the Club Player Safety Liaison person to report on games for their club.
If you are entering the information on behalf of the Liaison person then please note your name in the question below.
Any further reporting will be directed back to your clubs Player Safety person.
This form is to report only on your Clubs teams.

One form per game.
If there are multiple incidents for your team in one game then use one form per incident.

Club *

Name if not the registered person

If the person filling this form out is not the registered liaison person please also provide an email address for follow up communication.

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