| 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: | 2023-09-16 |
| Time of Incident: | 14:20:00 |
| Location of Incident: | Cohn Park Cohn 1 |
| Home Team: | Folsom Lake Surf FLS 15G Pink Team |
| Visiting Team: | Fair Oaks FC |
| Age Group and Gender: | U10G |
| Team Affiliation of Individual Committing Incident: | Folsom Lake Surf FLS 15G Pink Team |
| Incident Summary: | No game cards were present. |
| Comments: | This is not a PAD issue. If either team wishes to appeal the game, they should file a Game Appeal Form. |
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