| Type of Incident: | Spectator |
| Match Number: | |
| Date of Incident: | 2012-09-15 |
| Time of Incident: | 11:50:00 |
| Location of Incident: | Rincon Valley Community Park |
| Competition: | 2012_SOR_NCSC_ |
| Home Team: | Empire SC Arsenal |
| Visiting Team: | SCA 00B |
| Age Group and Gender: | U13B |
| Team Affiliation of Individual Committing Incident: | |
| Incident Summary: | Coach Send-off |
| Comments: | This should be submitted as a Coach Send off report. This incident is closed please complete send off report for coach |
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