| Type of Incident: | Injury |
| Match Number: | 6497 |
| Date of Incident: | 2021-10-17 |
| Time of Incident: | 01:45:00 |
| Location of Incident: | Sunrise Park Soccer Field, Rohnert Park |
| Competition: | 2021_SOR_FALL_ |
| Home Team: | Rebels |
| Visiting Team: | Copa White |
| Age Group and Gender: | U14B |
| Team Affiliation of Individual Committing Incident: | Copa White |
| Incident Summary: | Injury Report |
| Comments: | Injury Report - no action taken. |
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