GSYSL Referee
Missing Document Report
Game_____________ Referee____________
Date______________ Asst Referee________
Div_______________ Asst Referee________
Field______________
Home_____________
Away_____________
The following documents
or payments were not presented to the referee at game time.
[ ] 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____________
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@aol.com
CC: bmphome@aol.com
Mail to:
Steve Lewis
Nashua, NH 03063