| Type of Incident: | Sportsmanship — May be used if a team, player, coach, or spectator is involved. |
| Match Number: | 1234 |
| Date of Incident: | 2017-10-29 |
| Time of Incident: | 04:00:00 |
| Location of Incident: | Central Park Soccer Complex, Field 10 |
| Competition: | 2017_SOR_FALL_ |
| Home Team: | Lodi United FC 2004 Boys |
| Visiting Team: | PV United 04B Blue |
| Age Group and Gender: | U14B |
| Team Affiliation of Individual Committing Incident: | PV United 04B Blue |
| Incident Summary: | This occurred at a tournament. |
| Comments: | PAD does not rule on events that occurred at tournaments. |
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