| Type of Incident: | Sportsmanship — May be used if a team, player, coach, or spectator is involved. |
| Date of Incident: | 2023-09-17 |
| Time of Incident: | 14:00:00 |
| Location of Incident: | John Mise Park, San Jose |
| Home Team: | San Jose Rush 08B White |
| Visiting Team: | Santa Cruz Sharks 08 Blue |
| Age Group and Gender: | U16B |
| Team Affiliation of Individual Committing Incident: | San Jose Rush 08B White |
| Incident Summary: | Complaint about the decisions made by the referee and failure of the referee to list the numbers of the San Jose Rush players on the game card. |
| Comments: | The PAD takes no action. If you wish to appeal the game, please file a Competition Committee Report: https://system.gotsport.com/forms/2830H9382 |