WFTDA Interleague Game Reporting Form (IGRF)

Section 1. VENUE & ROSTERS (Complete BEFORE the game)

Trinitat Vella Centre Esportiu Municipal Barcelona
Location:
VENUE NAME CITY ST/PRV GAME #
Tournament/ Roller Derby Torneo Barcelona City Team Spain
Multi-Day Event: TOURNAMENT/MULTI-DAY EVENT NAME HOST LEAGUE NAME
Date: Start Time: Suspension: YES | NO
TEAM ROSTERS - List in order of Skater number
HOME TEAM VISITING TEAM
LEAGUE LEAGUE
TEAM TEAM
COLOR COLOR
# of players Skater # Skater Name # of players Skater # Skater Name
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
Section 2. SCORE & PENALTIES (Complete DURING or IMMEDIATELY AFTER game)
HOME TEAM VISITING TEAM
Period 1 Points Penalties Period 1 Points Penalties
Period 2 Points Penalties Period 2 Points Penalties
TOTAL POINTS: PENALTIES: TOTAL POINTS: PENALTIES:
The Official Score in this game required adjustment: Reason for OS adjustment:
Expulsion/Suspension notes: Suspension was served by:
Expulsion: Suspension: YES | NO

Expulsion: Suspension: YES | NO

Expulsion: Suspension: YES | NO

Section 3. VERIFICATION (Complete IMMEDIATELY AFTER game)

Home Team Captain Visiting Team Captain
Skate Name: Skate Name:
Legal Name: Legal Name:

Signature: Signature:
Head Referee Head NSO
Skate Name: Skate Name:
Legal Name: Legal Name:

Signature: Signature:

For Sanctioned games only: The host team follows the timeline and process for submitting required sanctioning data described in the WFTDA Sanctioning policy The current WFTDA
Sanctioning policy may be found at https://wftda.org/sanctioning
IGRF Rev. 170201 2017 Women's Flat Track Derby Association (WFTDA)

Form Printed: 1.8.2017

 Section 4. ROSTER OF NON-SKATING OFFICIALS/STAT TRACKERS/SKATING OFFICIALS
Official Name Official Role League Affiliation Certification Level
(Crew) Head Non-Skating Official
Penalty Tracker
Penalty Wrangler
Inside Whiteboard Operator
Jam Timer
Scorekeeper
Scorekeeper
Scoreboard Operator
Penalty Box Manager
Penalty Box Timer
Penalty Box Timer
Lineup Tracker
Lineup Tracker
Non-Skating Official Alternate
Period Timer

Head Referee
Inside Pack Referee
Jammer Referee
Jammer Referee
Outside Pack Referee
Outside Pack Referee
Outside Pack Referee
Referee Alternate
Optional Officials' roles appear in italics. Positions may be left empty, if not used in game. Additional positions may be added.

For Sanctioned games only: The host team follows the timeline and process for submitting required sanctioning data described in the WFTDA Sanctioning policy The current WFTDA
Sanctioning policy may be found at https://wftda.org/sanctioning
IGRF Rev. 170201 2017 Women's Flat Track Derby Association (WFTDA)

Form Printed: 1.8.2017