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Game Incident Report
Submit a Game Incident Report to Discipline and Appeals
Items marked with an asterisk (*) are required.
Reported By:
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*
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*
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*
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Team Information:
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*
IP
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Atom House
Minor Atom
Major Atom
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Level
*
AAA
AA
A
B
C
Other
Team Name
Player or Team Official being Reported
Name
Team Position
*
Player
Head Coach
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Manager
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Other
Player Number
Infraction
Game Date
*
Period
*
Before Game
1st Period
2nd Period
3rd Period
OT
Intermission
End of Game
Time on Clock
Infraction
*
M20 – harassment of official – 9.2A/B
M21 – not proceeding to penalty bench – 9.2D
M22 – inciting – 9.2E
M23 – referee’s crease – 9.2G
M24 – protective equipment – 3.6DEFG
M25 – failure to go to player’s bench – 6.7A
M26 – checking to the head (CTH) – 6.5A
GM30 – major penalty – 4.4A
GM31 – harassment of official – 9.2A/B
GM32 – discrimination / taunting – 9.2F
GM33 – 2nd misconduct of game – 4.5C
GM34 – 3rd player in (must be a fight) – 6.7C
GM36 – 2nd flight same stoppage – 6.7C
GM37 – leaving the players bench – 9.5B/C
GM38 – refuse to start – 10.14
GM39 – end of game – 10.15E
GM40 – checking from behind – 6.4E
GM41 – checking to the head – 6.5B
GM42 – fighting – 6.7A/B
GRM50 – travesty of game – 4.7B
GRM51 – removing helmet – 3.6Clar.2,4
GRM 52 – taunts, racial comments – 9.2F
GRM53 – fighting with team official – 6.7D
GRM54 – team official – head butt, butt end or spearing – 6.1BFG
MP60 – attempt to injure – 6.1A
MP62 – butt ending – 6.1F
MP62 – checking fro behind – 6.4B
MP63 – checking to the head – 6.5C
MP64 – grabbing hair, facemask, etc – 6.1D
MP65 – head butting – 6.1B
MP66 – kicking – 6.1C
MP67 – touching, holding, pushing – 9.6A
MP68 – strokes, trips, body checks – 9.6B
MP69 – threatens, attempts to strike – 9.6C
MP70 – spearing – 6.1G
OTHER: enter code in Comments with explanation
Minutes
Additional Infraction
M20 – harassment of official – 9.2A/B
M21 – not proceeding to penalty bench – 9.2D
M22 – inciting – 9.2E
M23 – referee’s crease – 9.2G
M24 – protective equipment – 3.6DEFG
M25 – failure to go to player’s bench – 6.7A
M26 – checking to the head (CTH) – 6.5A
GM30 – major penalty – 4.4A
GM31 – harassment of official – 9.2A/B
GM32 – discrimination / taunting – 9.2F
GM33 – 2nd misconduct of game – 4.5C
GM34 – 3rd player in (must be a fight) – 6.7C
GM36 – 2nd flight same stoppage – 6.7C
GM37 – leaving the players bench – 9.5B/C
GM38 – refuse to start – 10.14
GM39 – end of game – 10.15E
GM40 – checking from behind – 6.4E
GM41 – checking to the head – 6.5B
GM42 – fighting – 6.7A/B
GRM50 – travesty of game – 4.7B
GRM51 – removing helmet – 3.6Clar.2,4
GRM 52 – taunts, racial comments – 9.2F
GRM53 – fighting with team official – 6.7D
GRM54 – team official – head butt, butt end or spearing – 6.1BFG
MP60 – attempt to injure – 6.1A
MP62 – butt ending – 6.1F
MP62 – checking fro behind – 6.4B
MP63 – checking to the head – 6.5C
MP64 – grabbing hair, facemask, etc – 6.1D
MP65 – head butting – 6.1B
MP66 – kicking – 6.1C
MP67 – touching, holding, pushing – 9.6A
MP68 – strokes, trips, body checks – 9.6B
MP69 – threatens, attempts to strike – 9.6C
MP70 – spearing – 6.1G
OTHER: enter code in Comments with explanation
Minutes
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