Officials Incident Report

This form is for league officials only. It is not for parents, players, or others. Anything submitted by a non-official will be discarded.

Officials may use this form to report incidents at Dioceses of Pittsburgh elementary school athletic events. Incidents may include technical fouls assessed and ejections of spectators, coaches or players. The information is sent to the relevant League Director (Jack White), the Diocesan Athletic Director (Don Militzer) and the Official Assigner for the league.

To submit this form you must include at least the Incident Description, and either the Official's Name and the Official's Phone or the Submitter's Name and the Submitter's Phone.

Official's Name:

Official's Phone:

Event Date:

Bad date format

Event Level:

Select the event level from the drop down list.

Home School/Team:

Select the home school or team from the drop down list. If the home school or team is not in the drop down list include it in the Incident Description.

Visiting School/Team:

Select the visiting school or team from the drop down list. If the visiting school or team is not in the drop down list include it in the Incident Description.

Gym Location (indoor events):

If the gym location is not in the drop down list include it in the Incident Description.

Field Location (outdoor events):

If the field location is not in the drop down list include it in the Incident Description.

Incident Type:

Incident Description:

Describe the incident and make sure to include all relevant details.

If you are not the Official mentioned above and are simply reporting the incident, enter your name and phone number.

Submitters's Name:

Submitters's Phone: