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GSYSL Referee Missing Document Report

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GSYSL Referee Missing Document Report

  • Game#

  • Date:
  • Div:
  • Field:
  • Home Team:

  • Away Team:

  • Referee:

  • AR1:

  • AR2:

  • The following documents or payments were not presented to the referee at game time.

  • Circle one: Team roster | Referee payment | Coach’s Passes | Player Passes for entire team |Player Passes for the following players:

  • Player name:
  • Player number:

  • Player name:
  • Player number:

  • Player name:
  • Player number:

  • Player name:
  • Player number:


  • Player name:
  • Player number:

  • Player name:
  • Player number:

  • Reason for missing documents (please explain):

  • Coach’s Acknowledgement I, as coach of the ____ (team) acknowledge that the above indicated documentation was missing at game time but attest that all players are duly registered and on my team roster, in good standing, are not suspended, and are eligible to play in this game. I am aware that there is a $250 GSYSL fee that may be assessed if players are used in a game that are ineligible, and that I am responsible for paying the fee penalty if assessed.

  • Coach’s Name (print):
  • Coach’s Signature (sign):
  • Referee’s Signature (sign):

  • Email to: smlewis@granitestatesoccer.com CC: JBVJW@aol.com

  • Mail to: Steve Lewis 5 Ferncroft Dr Nashua, NH 03063

© 2012 Granite State Youth Soccer League
All rights reserved.
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GSYSL
122 Bridge St. Unit #1
Pelham, NH 03076