| Type of Incident: | Injury |
| Match Number: | 1629 |
| Date of Incident: | 2023-11-12 |
| Time of Incident: | 12:35:00 |
| Location of Incident: | AR1 touchline even with the top of penalty area |
| Competition: | 2023 National Premier League |
| Home Team: | WC Surf 09G |
| Visiting Team: | Elk Grove Soccer 09G |
| Age Group and Gender: | U15G |
| Team Affiliation of Individual Committing Incident: | Elk Grove Soccer 09G |
| Incident Summary: | Injury Report. |
| Comments: | Injury Report - no action taken. |
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