| Type of Incident: | Other — Do not use if a team, player, coach, or spectator is involved. Use only if the incident cannot be classified as any other Type of Incident above. |
| Date of Incident: | 2024-10-13 |
| Time of Incident: | 14:00:00 |
| Location of Incident: | Davis Legacy Soccer Complex |
| Home Team: | |
| Visiting Team: | |
| Age Group and Gender: | U12B |
| Team Affiliation of Individual Committing Incident: | |
| Incident Summary: | This has been handled by the Competitions Committee. |
| Comments: | This is not a PAD issue and has been resolved by the Competitions Committee. |