This form is to protect the player/coach and the league
Please print and fill out completely!
Name & STYSA ID # _________________________________________________
Team ________________________________________________________
Age Group _______________ Boys ______ Girls ___________
Date of Game _____________ Opponent _______________________
Coach/Manager ___________________________
Phone _____________
Signatures below certify that the above named individual did not
participate in the above dated game.
Referee _____________________________________ Date____________
Coach/Manager ________________________________
Date _________
This form must be completed and sent to the TYSA Scorekeeper with the game reports if
the person named is to receive credit for sitting out the required games. Failure to
comply may result in disciplinary action against the coach and player.
