Date of Game: _________________________ Location: ________________________________
 

Home Team: __________________________ Visiting Team: ____________________________
 

Person Filling Out Report: _____________________________________________________________
 

Daytime Phone: ________________________ Email address: _____________________________

The following report must be submitted to the appropriate ACHA commissioner within 48 hours of the incidence occurring.  Based on the report and supporting score sheet and/or video, the commissioner will provide a ruling.  The ruling may be appealed to the appropriate rules committee.