| Type of Incident: | Player |
| Match Number: | |
| Date of Incident: | 2013-09-21 |
| Time of Incident: | 04:25:00 |
| Location of Incident: | Mayfield South, Palo Alto CA |
| Competition: | 2013_SOR_FALL_ |
| Home Team: | United 00B Red |
| Visiting Team: | 01B Blue |
| Age Group and Gender: | U13B |
| Team Affiliation of Individual Committing Incident: | United 00B Red |
| Incident Summary: | Injury Reported - please contact US Club Soccer for any needed insurance information |
| Comments: | |
English