Incident Report Form

Incident Report Number

This is a unique number generated automatically upon opening the form.

Levels of Offences on this report

Name of person filling out this incident report.

First

Last

Email Address of the reporting person

Who is sending in this report? This should be an accredited umpire or a club official.

Grade

Date of breach

Home team

Away team

Home Team’s captain

Home Team's captain

First

Last

Away Team’s captain

Away Team's captain

First

Last

Umpire 1

Umpire 2

Player/Official Charged (1)

First

Last

Club

Mobile Number

Has the player been informed of this report?

Yes

No

What level of offence has this player/offical been charged?

Section 1 – Level 1 or Level 2 Offence

Section 2 – Level 3 or Level 4 Offence

NOTE: only certified umpires can ascertain the level of offence. If you are not an umpire, then this level with be indicative only.

Section 1 Level of offences

Section 2 Level of Offences

Player 1 – Level 4 Offences

Nil

1.12 Inappropriate physical contact with a Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.17 Threat of assault on another Player, Player Support Personnel, Umpire or Match Ofﬁcial or any other person (including a Spectator) during a Match.

1.18 Physical assault of another Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.19 Any act of violence on the ﬁeld of play during a Match.

1.20 Conduct that is contrary to the spirit of the game.

1.21 Conduct that brings the game into disrepute.

1.22 Racial/Religious/Gender/Disability/Sexuality abuse of a Player, Player Support Personnel, Umpire or Match Ofﬁcial during a Match.

Check the “Appendix A – Levels of Offence” in the CFN Code of Behaviour 2023-2024 document for details on each level.

Is there a second player or official to be reported?

Yes

No

What level of offence has this 2nd player/official been charged?

Section 1 – Level 1 or Level 2 Offence

Section 2 – Level 3 or Level 4 Offence

Player/Official Charged (2)

First

Last

Club

Mobile Number

Has the player been informed of this report?

Yes

No

Section 1 Level of offences (Player 2)

Section 2 Level of Offences (Person 2)

Person 2 – Level 4 Offences

Nil

1.12 Inappropriate physical contact with a Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.17 Threat of assault on another Player, Player Support Personnel, Umpire or Match Ofﬁcial or any other person (including a Spectator) during a Match.

1.18 Physical assault of another Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.19 Any act of violence on the ﬁeld of play during a Match.

1.20 Conduct that is contrary to the spirit of the game.

1.21 Conduct that brings the game into disrepute.

1.22 Racial/Religious/Gender/Disability/Sexuality abuse of a Player, Player Support Personnel, Umpire or Match Ofﬁcial during a Match.

Check the “Appendix A – Levels of Offence” in the CFN Code of Behaviour 2023-2024 document for details on each level.

Is there a third player or official to be reported?

Yes

No

What level of offence has this 3rd player/official been charged?

Section 1 – Level 1 or Level 2 Offence

Section 2 – Level 3 or Level 4 Offence

Player/Official Charged (3)

First

Last

Club

Mobile Number

Has the player been informed of this report?

Yes

No

Section 1 Level of offences (Player 3)

Section 2 Level of Offences (Person 3)

Person 3 – Level 4 Offences

Nil

1.12 Inappropriate physical contact with a Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.17 Threat of assault on another Player, Player Support Personnel, Umpire or Match Ofﬁcial or any other person (including a Spectator) during a Match.

1.18 Physical assault of another Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.19 Any act of violence on the ﬁeld of play during a Match.

1.20 Conduct that is contrary to the spirit of the game.

1.21 Conduct that brings the game into disrepute.

1.22 Racial/Religious/Gender/Disability/Sexuality abuse of a Player, Player Support Personnel, Umpire or Match Ofﬁcial during a Match.

Check the “Appendix A – Levels of Offence” in the CFN Code of Behaviour 2023-2024 document for details on each level.

Is there a fourth player or official to be reported?

Yes

No

What level of offence has this 4th player/official been charged?

Section 1 – Level 1 or Level 2 Offence

Section 2 – Level 3 or Level 4 Offence

Player/Official Charged (4)

First

Last

Club

Mobile Number

Has the player been informed of this report?

Yes

No

Section 1 Level of offences (Player 4)

Section 2 Level of Offences (Person 4)

Person 4 – Level 4 Offences

Nil

1.12 Inappropriate physical contact with a Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.17 Threat of assault on another Player, Player Support Personnel, Umpire or Match Ofﬁcial or any other person (including a Spectator) during a Match.

1.18 Physical assault of another Player, Player Support Personnel, Umpire, Match Ofﬁcial or any other person (including a spectator) during a Match.

1.19 Any act of violence on the ﬁeld of play during a Match.

1.20 Conduct that is contrary to the spirit of the game.

1.21 Conduct that brings the game into disrepute.

1.22 Racial/Religious/Gender/Disability/Sexuality abuse of a Player, Player Support Personnel, Umpire or Match Ofﬁcial during a Match.

Check the “Appendix A – Levels of Offence” in the CFN Code of Behaviour 2023-2024 document for details on each level.

Full details of all breaches on ALL players/Officials charged must be entered here.

Detail each charged player/official in the order they are listed above.

Section 1 Level of offences

Section 2 Level of Offences

Section 1 Level of offences (Player 2)

Section 2 Level of Offences (Person 2)

Section 1 Level of offences (Player 3)

Section 2 Level of Offences (Person 3)

Section 1 Level of offences (Player 4)

Section 2 Level of Offences (Person 4)

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