| 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: | 2018-07-22 |
| Time of Incident: | 10:00:00 |
| Location of Incident: | Northwest Park Upper |
| Home Team: | Dixon SC Leon 04B |
| Visiting Team: | Central Valley Premier FC Classic B04 |
| Age Group and Gender: | U15B |
| Team Affiliation of Individual Committing Incident: | Central Valley Premier FC Classic B04 |
| Incident Summary: | Central Valley failed to appear for a match. |
| Comments: | Please contact the Event Coordinator, this is not a PAD issue. |
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