| League Match: |
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| Club: |
|
| Name: |
|
| Email: |
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| Phone: |
|
| |
|
| Match Date: |
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| Match Venue / Pitch: |
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| Kick Off Time: |
|
| Home Team: |
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Score
|
Tries
|
| Visiting Team: |
|
Score
|
Tries
|
| |
|
| Referee: |
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| Name of TJ 1: |
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| Name of TJ 2: |
|
| |
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| Field Properly Marked: |
If No, explain
|
| Posts, Pads, and Ropes: |
If No, explain
|
| |
|
SCORES FOR YOUR TEAM |
| Scoring Player: |
|
Method
|
Points
|
| Scoring Player: |
|
Method
|
Points
|
| Scoring Player: |
|
Method
|
Points
|
| Scoring Player: |
|
Method
|
Points
|
| Scoring Player: |
|
Method
|
Points
|
| Scoring Player: |
|
Method
|
Points
|
| Additional Scoring: |
|
| |
|
GAME DAY ELIGIBILITY PROCEDURES |
Player Eligibility |
Did you download opposition's CIPP Roster? |
|
|
Did you compare the opposition's match roster with CIPP roster? |
|
Were there any discrepancies between the match and CIPP rosters? |
|
| If you answered "Yes" to the above question, please list the names of the players in question. |
|
Did your clubs conduct a photo ID check before the start of the match? |
|
| |
|
Club Matches Only |
Did you check any players for citizen status? |
|
List the names of any players from the opposing team that you believe may be ineligible. |
|
| |
|
Collegiate Matches Only |
|
Did both teams present a completed Collegiate Eligibility Form? |
|
Did any players participate who were not on the Collegiate Eligibility Form? |
|
|
List the names of any players from the opposing team that you believe may be ineligible. |
|
| |
|
| |
|
| |
|
ROSTER |
CIPP |
Last Name, First Name |
| #1
|
|
| #2
|
|
| #3
|
|
| #4
|
|
| #5
|
|
| #6
|
|
| #7
|
|
| #8
|
|
| #9
|
|
| #10
|
|
| #11
|
|
| #12
|
|
| #13
|
|
| #14
|
|
| #15
|
|
| #16
|
|
Replaced # |
|
| #17
|
|
Replaced # |
|
| #18
|
|
Replaced # |
|
| #19
|
|
Replaced # |
|
| #20
|
|
Replaced # |
|
| #21
|
|
Replaced # |
|
| #22
|
|
Replaced # |
|
| |
|
| NOTES: |
|
