CIF-SS DISQUALIFICATIONS MUST BE FAXED TO (562-493-6266) ATTN: Karren Hellyer
L A CITY DISQ2UALIFICATIONS MUST BE FAXED TO (213-746-6390) ATTN: Barbara Fiege

LEVEL OF GAME: V JV FS           TYPE OF GAME: BOYS GIRLS

( ) ( )
          Home Team Name                         Final Score            Visiting Team Name                             Final Score

Head Official:	Last	First	Home Phone
Official:	Last	First	Home Phone

Day of Game:      Date of Game: (MM-DD-YYYY)

Reasons for Cautions: (Yellow Card)	2ndYellow/ (Red Card)	Disqualification (Red Card)
A) Leaves the field without permission	G) TAUNTING (Yellow/Red Card)	O) Invasion of field
B) Shown dissent, by work or action	H) Leaves field without permission	Q) Guilty of Serious foul play
C) Persistently infringing laws of the game	I) Shows dissent by word or action	R) Spits at opponent or person
D) Guilty of unsporting behavior	J) Persistently infringing laws of the game	S) Denies goal scoring opportunity by hand ball
E) Enters field without permission	K) Guilty of unsporting behavior	T) Denies goal scoring opportunity by fouling opponent
F) Delays restart of play	L) Enters field without permission	U) Uses offensive, insulting, or abusive language
	M) Fails to respect distance on restart	V) Fighting
	N) Delays restart of play

Last Name	First Name	Jersey #	Name of Players Team	Reason (USED)
Player	Head Coach	Asst. Coach
Detailed Explanation for each Disqualification:

Last Name	First Name	Jersey #	Name of Players Team	Reason (USED)
Player	Head Coach	Asst. Coach
Detailed Explanation for each Disqualification:

Fax within 24 Hours to:
San Gabriel Valley Chapter
Name: TONY VASQUEZ
E-Mail AVasq23996@aol.com
Res. Phone :  323-221-3090
Fax Number : 323-221-3090