Capital Women's & Girls Cup Competitions

All sections of this form must be completed, only substititutes that played in the game are to be named

Date Played * +

Competition *

Tie No *

Round *

Home Club *

Away Club *

Home Team No *

Away Team No *

Score after normal time *

Score after penalties

Please List the names of your players below

For Under 12's & U'14s please type in N/A for players in excess of 9v9 and 7v7

10.

11.

Substitutes up to 5

Referee :: Initial *

Surname *

Mike Brown should be shown as

[Initial] M [Surname] Brown

Mark *

/ 100

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Assistant Referee :: Initial	-
Assistant Referee :: Initial	-

	-
Surname	-
Surname	-

Your Name *

Your Club *

Your email address *

Please re-enter *

Comments Box

Use this area to report late/non confirmation

If you give the referee a mark of 60 or lower, please send a written report to the Administering County using the guidleines set out in the Rules

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