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24-Hour Referee Send Off Report

  1. Please complete the following Referee's Send Off Report Form for any player or coach that you sent off in your match.
  2. Submit one form per individual that is sent off.
  3. When you submit the form, an email will be sent to you with an attachment of the PDF of the CYSAN Referee Send Off Report pre-filled. Print this report, and mail it together with the sent off person's card to:
Cary A. Jones
36 Dunsmuir St.
San Francisco, CA 94134

Required fields are indicated with a red asterisk (*).

Match Information

This form may be used for the following competitions only. For all CCSL games, use the Referee's Send Off Report Form at

Sent Off Individual's Information

Opposing Team Information
Referees Information
After submitting your information, an email will be sent to you with further instructions.