| 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: | 2024-11-10 |
| Time of Incident: | 12:00:00 |
| Location of Incident: | Wilson Ranch Soccer Park |
| Home Team: | |
| Visiting Team: | |
| Age Group and Gender: | U13B |
| Team Affiliation of Individual Committing Incident: | |
| Incident Summary: | Multiple players were written into the roster. All of the players are members of the club. |
| Comments: | If you wish to protest the result, please file a PAD Match Report. |
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