The ON REPORT signal has been developed to be used on the following occasions Minor Verbal Abuse of a match official When dismissal is not warranted As another “on field tool” to assist the referee and touch judge in maintaining control

ACTION BY CLUB FOR A PLAYER WHO HAS BEEN PLACED ON REPORT DATE: __________ CLUB:_________________________ PLAYER’S NAME: _______________________________________ MATCH:_________________________V____________________________ DATE OF MATCH: __________________________________ GRADE:_______________ TO: The Group 2 Operations Manager BELLINGEN: james Fax: I would like to report that the above player has had the following action(s) taken against him as a result of being put “on report” for abuse of a match official: (Tick one or more of the boxes below.) □Has been verbally reprimanded by our club □Has been fined an amount of $___________ □Has been voluntarily suspended for _________ competition matches. □Wishes to offer an apology to the match official for his abuse. □Has given our club an assurance it won’t happen again. □Has been placed on a $______ bond for ____matches. _______________________________ ____________________________ Player’s Signature Club Representative’s Signature

PLEASE MAKE YOURSELF FAMILIAR WITH THE “ON REPORT” PROCEDURES AND USE IT IT IS THERE TO HELP YOU AS A REFEREE AND TOUCH JUDGE REFEREE SMARTER NOT HARDER!