| 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: | 2016-09-17 |
| Time of Incident: | 11:00:00 |
| Location of Incident: | Stockton (Chadwick Square) |
| Home Team: | Monarcas Academy 03 |
| Visiting Team: | Ceres Earthquake FC Warriors Jr. |
| Age Group and Gender: | U14B |
| Team Affiliation of Individual Committing Incident: | Monarcas Academy 03 |
| Incident Summary: | Allegation that a number of NPL rules were violated. |
| Comments: | This is not a PAD issue, please contact the Event Coordinator. |
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