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Misconduct Form/Ejection Report
This form must be filled out and submitted within 24 hours of incident. Any MISCONDUCT By Coaches, Players or Fans. Also include all actions by umpire/s Please indicate any actions taken by coaches, fans etc. after corrective measures have been taken by umpires.
2020 Varsity Game Report
This form must be filled out and submitted within 24 hours of incident. Any MISCONDUCT By Coaches, Players or Fans. Also include all actions by umpire/s Please indicate any actions taken by coaches, fans etc. after corrective measures have been taken by umpires.
E S B U A New Candidate Registration Form
If you are interested in joining our group and attending our Candidate Class, please fill out this form.
ESBUA UMPIRE INFORMATION
Members Please fill out form so we have correct information on all of our members.
Accident Report
ACCIDENT REPORT
Date of this report________________________
Name of school official in charge __________________________________________________________
Assigned official’s names ________________________________________________________________
Date of incident ______________________ Time of incident ___________________________________
Name of injured _______________________________________________________________________
Contested sport ______________________Level of competition ________________________________
Location of contest _____________________________________________________________________
Schools competing _____________________________________________________________________
_____________________________________________________________________________________
Weather conditions ____________________________________________________________________
Type of suspected injury _________________________________________________________________
Name(s) of school official(s) treating suspected injury, if any treatment was given___________________
_____________________________________________________________________________________
Description of incident __________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Action taken by school official(s) in charge __________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Name(s) and action taken by others administering to suspected injury ____________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Name(s) and telephone numbers of witnesses’ _______________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Name and address of official making this report ______________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Send to:
Marsh USA, Inc. Robert E. Stulmaker,
175 Sully’s Trail Assistant Director
Suite 301 NYSPHSAA
Pittsfield, NY 14534-4560 8 Airport Park Blvd.
Latham, NY 12110