| Type of Incident: | Other — Do not use if a team, player, coach, or spectator is involved.  Use only if the incident cannot be classified as any other Type of Incident above. | 
| Date of Incident: | 2022-09-17 | 
| Time of Incident: | 10:00:00 | 
| Location of Incident: | TENNYSON HIGH SCHOOL - Tennyson turf | 
| Home Team: | Tecos Hayward soccer club Tecos SWB | 
| Visiting Team: | Oakland soccer club 04b | 
| Age Group and Gender: | U19B | 
| Team Affiliation of Individual Committing Incident: | Tecos Hayward soccer club Tecos SWB | 
| Incident Summary: | Please see Incident 4504. | 
| Comments: | Please see Incident 4504. |