Your name:
Email address:

Which team do you represent?
Christ Church Cornerstone Alpha Cornerstone Omega (reserves) Croxley Baptists Hemel Army Kings Sports A Milton Keynes Churches Potter Street Baptists St. Albans Romans St. Albans Romans Reserves St. Georges Stopsley Baptists Thorley St James Three Churches Welwyn St. Marys Welwyn St. Marys Reserves Other, please specify
Other:

Which team did you play?
Christ Church Cornerstone Alpha Cornerstone Omega (reserves) Croxley Baptists Hemel Army Kings Sports A Milton Keynes Churches Potter Street Baptists St. Albans Romans St. Albans Romans Reserves St. Georges Stopsley Baptists Thorley St James Three Churches Welwyn St. Marys Welwyn St. Marys Reserves Other, please specify
Other:

What was the date of the fixture?

What was the nature of the fixture?
League Division 1        League Division 2        Cup        Friendly

Were you Home or Away?
Home        Away

What was the score at half-time?
(Home team goals first)

What was the score at full-time?
(Home team goals first)

What was the score after extra-time?
(Leave blank if not applicable)

What was the score after penalties?
(Leave blank if not applicable)

Who were your goal scorers?
(If possible, please list scorers of most goals first and then list players alphabetically by surname)
E.g. Stuart Pearce (3 (1 pen)) Peter Beardsley (2) Paul Merson Peter Shilton

What was the referee's name?

How would you rate the referee's performance?
(A separate report should be submitted with any rating of 4 or below)
10 - Excellent 9 8 7 - Adequate 6 5 4 - Unsatisfactory 3 2 1

Brief reason for any referee score of 4 or below

How would you rate your opponents Sportsmanship?
(A separate report should be submitted with any rating of 2 or below)
5 - Excellent 4 - Good 3 - Satisfactory 2 - Poor 1 - Cause for concern

Brief reason for any fair play score of 2 or below

Were there any yellow or red cards?
(Please list players from both sides, use the codes below to give details if possible)
eg Team name A: John McEnroe (Y2, Y2, R7) Team name B: Unknown (Y3)

Codes for Yellow cards	Codes for Red cards
Y1 - Unsporting behaviour.	R1 - Serious foul play.
Y2 - Dissent by word or action.	R2 - Violent conduct.
Y3 - Persistently infringing the Laws.	R3 - Spitting.
Y4 - Delays restart of play.	R4 - Denies a goal by hand.
Y5 - Fails to respect 10 yards.	R5 - Denies a goal by other action.
Y6 - Enters Field without permission.	R6 - Unacceptable language or gesture.
Y7 - Leaves Field without permission.	R7 - Receives a 2nd yellow.