Hockey Wales / Hoci Cymru

Section A: RED CARD (for offences during a game)

This form is to be used as the recording document following the issue of a Red Card or Technical Red Card applicable to men's, women's, mixed, senior and junior hockey including those played at school, club and representative level. It is to be posted/faxed/emailed to the Regional Disciplinary Officer (as per the guidance on the reverse side of the form) within 3 days of the incident. The form is to be completed by the umpire issuing the red card: the second umpire may comment if they wish in section 14. For Match Day Misconduct (MMO) reports please see Section B overleaf

Please PRINT all details and tick appropriate boxes 1. Full name of person awarded red card: HW Registration Number (if known): 2. Name of person's club: 3. Title of competition if applicable 4. Date and venue of match 5. Name of home team: 6. Name of visiting team:

7. Please tick the applicable box indicating why the Red Card was issued.

A An offence in which physical violence is not used, offered or threatened. B An offence that involved violence being offered or threatened to a player. C An offence that involved violence being offered or threatened to any other person (i.e. coach, physio, spectator etc.). Please record the person's name and their position / role at the match / event. D An offence that involved violence being offered or threatened to an umpire or properly appointed tournament or match official. E An offence that involved violence being used on a player. F An offence that involved violence being used on any other person (i.e. coach, physio, spectator). Please record the person's name and their position / role at the match / event G An offence that involved violence being used on an umpire or properly appointed tournament or match official. H Two separate, but duplicate, minor offences for which a yellow card was awarded for the first offence.

8. Please provide details of the incident leading to the issue of the Red Card: (Use additional page if necessary)

9. Name and qualification of umpire who issued the red card (WHUA Level 1 etc.):

10. Daytime Tel No of Umpire 11. E-mail address:

11. Signature of umpire issuing card: 12. Date:

13. Name and qualification of second umpire:

14. Optional additional comments /endorsement by second umpire:

Signature of second umpire: Date: (applicable if Section 14 completed)

Red Card Report Form Section B – MATCH DAY MISCONDUCT (for offences outside the game)

Offences apply to incidents and offences committed outside the game (i.e. not within the normal 70 minutes playing time). They represent reports of any misconduct prejudicial to Hockey Wales, any one of its constituent bodies or to the sport of hockey. They do not include drug abuse as this area has a separate Policy. Upon completion of the report it is to be posted or emailed to the appropriate Regional Disciplinary Officer within 3 days of the incident. Please attach a separate sheet of paper if you require additional space.

1. Full name of person you are reporting: (Please tick if U-18 on day of incident  2. Role of Person 3. Name of person's club: 4. Title of competition (if applicable) 5. Date of incident 6. Venue of incident 7. Full details of incident indicating exactly why it is considered an MMO. Please include name and contact details of any witnesses.

8. Name of person raising report: 9. Daytime telephone number: 10. Evening telephone number:

Both Red card and MMO reports are to be sent to the respective Regional Disciplinary Officer whose details can be found below.

South Wales Men John Taylor [email protected] 07450 538279

South Wales Women Jane Price [email protected] 07714 769784

North Wales Men & Women Jeff Hodge [email protected]

Red Card Report Form