ERRFU Club Match Report Form

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FORM MUST BE COMPLETED THOROUGHLY

League Match:	Yes No
Club:
Type:	High School Boys College Boys Mens Club -------- High School Girls College Girls Womens Club -------- Tournament Friendly Other
Name:
Email:
Phone:
Match Date:
Match Venue / Pitch:
Kick Off Time:
Home Team:		Score	Tries
Visiting Team:		Score	Tries
Referee:
Name of TJ 1:
Name of TJ 2:
Field Properly Marked:	Yes No If No, explain
Posts, Pads, and Ropes:	Yes No 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?			Yes No
Did you compare the opposition's match roster with CIPP roster?			Yes No
Were there any discrepancies between the match and CIPP rosters?			Yes No
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?			Yes No
Club Matches Only
Did you check any players for citizen status?			Yes No
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?			Yes No
Did any players participate who were not on the Collegiate Eligibility Form?			Yes No
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:

 

COACHES: In an effort to improve referee performance, please take a moment to fill in the Referee Evauation form below.

COMPONENT	COMMENTS	SCORE
Tackle		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Advantage		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Ruck/Maul		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Open Play		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Scrum		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Lineout		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Control		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Communication		--- Scoring --- 5=Very Effective 4=Effective 3=No Impact 2= Ineffective 1= Totally Ineffective
Critical Incidents

 

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