Ohio Water Polo Referees Association (OWPRA)
Incident Report Form


This report is to be filed within 48 hours of the incident.


A referee (or head referee, if applicable) shall report any of the incidents listed below to OWPRA's Supervisor and the Coaches' Representative. To do so, simply complete this form and submit it using the "submit" button. Note that items marked with an asterisk (*) are required.

Reportable incidents include (but may not be limited to):

  • Red card (given to a player, coach or any other team official.
  • Brutality foul (flagrant misconduct)
  • Game misconduct foul for violence
  • Game misconduct for misconduct (only if it involves obscene, abusive or threatening language, violent or persistant foul play, or disobedience or disrespect towards the referee; exiting the pool illegally is not a reportable incident).
  • Player injury involving bleeding or requiring medical attention (minor injuries, including those involving ice, are not reportable)
  • Game protest
  • "Other" (at the referee's discretion)



(*)Today's date (MM/DD/YYYY):

(*)Your name:

(*)Your e-mail address:

Home (or Primary) phone number (XXX-XXX-XXXX):

What incident(s) are your reporting (select any/all that apply from the following options):
Red card
Brutality foul (flagrant misconduct)
Game misconduct for violence
Game misconduct for misconduct
Player injury
Game protest
"Other"

If you selected "other" in the above menu, please describe the nature of the incident in the following text box:


In the following text box, please describe completely the physical conditions under which the incidents occurred. For example, where and when (date, time, location) did the incident occur, which teams were playing, when during the game did the incident occur, etc.



In the following text box, please describe completely the incident itself. This should include the name(s) of the individuals involved, and a complete description of all circumstances surrounding the incident.



If you have any additional information regarding the incident that was not included above, or if you want to make any comments about the incident, please enter this information in the following text box.





If you would like to retain a copy of this form for your records, click here to print the form.