Delco Soccer League - Referee's Game Report

This form is ONLY to be used for reporting DELCO games WITHOUT INCIDENTS. In any game where there is an injury or a player or coach is sent off, you MUST follow the current requirements for completing a Game Report and a Referee Incident Report and mail those forms to Goose Gosselin 316 Memorial Park Drive, Springfield, Pa 19064. Review all information before clicking on the Submit Button. When you have completed all sections of the form click on the submit button and then print and retain this report for your files.

Select a Year/Season:
Select a game to report:

Enter your email address:

**Home & Away Team Questions**
NOTE: click a check box to answer Yes, leave blank for No answers.
Home Team		Away Team
Home team on the field on time?		Away team on the field on time?
If not, how late?		If not, how late?
Home team first half score		Away team first half score
Home team final score		Away team final score
I received and retained a copy of the home team lineup?		I received and retained a copy of the away team lineup?
Home Team Conduct & Injuries		Away Team Conduct & Injuries
Players		Players
Coaches		Coaches
Parents		Parents
Cautions		Cautions
Ejections		Ejections
Serious Injuries		Serious Injuries

**Field Conditions, Weather, Game Time Information, & Referee Information**
Field Conditions, Weather, & Game Time Information		Referee Information & Ratings
FieldCondition		Referee's name:
Marking of field?		Referee grade?
Corner Flags?		Referee fee received?
Nets Okay?		First assistant referee name:
Weather?		First assistant referee grade?
Game Time Information		First assistant referee fee received?
Actual start time of game?		Second assistant referee name:
End of game time?		Second assistant referee grade?
		Second assistant referee fee received?
		Referee Assignor:

IF THERE WERE ANY SERIOUS INJURIES OR EJECTIONS YOU MUST FOLLOW THE CURRENT PROCESS FOR COMPLETING A GAME REPORT AND A SUPPLEMENTAL REFEREE INCIDENT REPORT FORM AND MAIL TO Goose Gosselin 316 Memorial Park Drive, Springfield, Pa 19064 WITHIN 48 HOURS. If you need to speak to Goose directly you can contact him at 610-328-5256. His email is refereeliaison@delcosoccer.org