GEORGIA HIGH SCHOOL ASSOCIATION P.O. BOX 271 THOMASTON, GA 30286-0004 Phone: 706-647-7473 / Fax: 706-647-2638 GAME REPORT

Officials Association: LFOA Game: Visiting Team: vs Home Team: Site: (City) Date:

SPORT: Baseball Football Soccer Swimming Basketball – Boys Gymnastics Softball – Fast Pitch Volleyball Basketball – Girls Lacrosse Softball – Slow Pitch Wrestling

TYPE OF REPORT:

Disqualification Forfeited Game Other Soccer – Two Yellow Cards/Red Serious Injury Soccer – Red Card Field Conditions Player or Coach Committing Violation Number Team Rule Violation or Infraction Example: John Doe #30 GHSA H.S. Taunting (Soccer Rule 12-8-2a)

Check when incident occurred: st nd rd th 1 Qtr 2 Qtr 3 Qtr 4 Qtr Before Game After Game Halftime Give brief factual narratives of violation without any editorial comments:

Official Making Report: Date: Date Forwarded to GHSA: (Signed – Secretary of Association)