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Lodge a Report

BV Report Form

THIS FORM IS TO BE COMPLETED BY REFEREES OR SUPERVISORS ONLY WHO WISH TO LODGE A BASKETBALL VICTORIA REPORT.

For any feedback or complaints regarding referees, please email refereeadvisor@bulleenboomers.com.au

Report Details
Date of Match
Scheduled Match Time*

: HH

MM
Approximate Time of Incident*
E.g. "2nd half 8:56mins remaining"
Venue*
Association Name*
I am reporting a*
- Player
- Team
- Coach
- Spectator / Other
Name Of Reported Person*
If unknown, please write unknown in the above box
Player Singlet Number*
Team Name*
Charges Against A Non-Official
This area is for incidents where behaviours are directed towards a player, coach, spectator or any non-official.
The below charges are for individuals reported for behaviour directed at other players, coaches and participants who are not the referees / officials.

Place an "X" in each box next to each relevant charge below.

You can read the BV description of charges here. (Maximum weeks penalty is displayed in brackets next to each charge).
Charges Against A Non-Official*
- Assault (52*)
- Attempt to Elbow (10*)
- Attempt to Kick (10*)
- Attempt to Strike (10*)
- Attempt to Trip (10*)
- Elbowing (20*)
- Kicking (20*)
- Obscene Gesture (10*)
- Offensive Language (10*)
- Putting in Fear (52*)
- Spitting (20*)
- Striking (52*)
- Threatening (52*)
Charges Against An Official
This area is for incidents where behaviours are directed towards a referee or scorer or an other official.
The below charges are for individuals reported for behaviour directed at referees or officials.

Place an "X" in each box next to each relevant charge below.

You can read the BV description of charges here. (Maximum weeks penalty is displayed in brackets next to each charge).
Charges Against An Official*
- Assault (Life*)
- Attempt to Elbow (52*)
- Attempt to Kick (52*)
- Attempt to Strike (52*)
- Attempt to Trip (52*)
- Elbowing (Life*)
- Kicking (Life*)
- Obscene Gesture (20*)
- Offensive Language (20*)
- Putting in Fear (104*)
- Spitting (52*)
- Striking (Life*)
- Threatening (104*)
- Tripping (Life*)
Conduct Charges
This area is for all behaviours related to the report
The below charges are for individuals reported for any behaviour. It is recommended referees consider the charges of "Bringing Basketball into Disrepute", "Gross Breach of Code" and "Unsportsmanlike Behaviour" for all reports.

Place an "X" in each box next to each relevant charge below.

You can read the BV description of charges here. (Maximum weeks penalty is displayed in brackets next to each charge).
Conduct Charges
- Avoidable Contact With Official (52*)
- Bringing Basketball into Disrepute (19*)
- Cause Damage (16*)
- Cause Injury (16*)
- Cheating (life*)
- Contempt (20*)
- Disputing Decisions (6*)
- Endanger with Blood, etc. (Life*)
- Fighting (20*)
- Gross Breach of Code (6*)
- Participate While Suspended (2-5*)
- Tunnelling (104*)
- Unsportsmanlike Behaviour (6*)
Alternative Procedure - Major or Minor Report
This area is for officials to select if the report is serious enough that a tribunal hearing is required
Please seek advice from your supervisor or Referee Advisor before indicating if this should be a minor or major report.
Is this a minor report and suitable for alternative procedure?*
- Yes, this is a minor report with less than 20 weeks the likely penalty and does not require a tribunal hearing
- No, this is a major report and requires a tribunal hearing
Which day/s would you be available for a tribunal hearing?*
- Monday after 6.30pm
- Tuesday after 6.30pm
- Wednesday after 6.30pm
- Thursday after 6.30pm
Description of Charges
This area is for describing the incident that is being reported
When writing your description, please read the following example to help you formulate yours. Please clearly write in any swear words you heard and be as clear as possible with your description:

E.g. At approximately 9.55pm on Monday 19th July I was asked by Tayla Flint to talk to Reece Carmichal of team The Wolf Pack At this point there was myself, Tayla Flint, Amy Jarvis, Reece Camichal and Reece’s girlfriend. When I came out of the referee’s room and before I could say anything, he became instantly abusive at me. Some of the things Reece said included: “She (referring to Rhiannon) is an immature, incompetent rat! Your ref’s are all fucking incompetent! They’re fucking shit! They don’t even know the fucking rules! You’ve got fucking useless people working for you! And you’re supposed to be the [glares down to read my name badge] fucking referee’s supervisor. What a joke! Their fucking useless! You need to fucking train them or something! They’re all a bunch of fucking degenerate rats!” At that stage I felt that it was useless trying to talk to Reece as he was trying to intimidate and bully me like he had done to the others. Then his girl friend started to have a say so I put my hand up for her to stop and said I was only talking to Reece at which he told me get to get my fuckin hand down I just looked at him and then said “I don’t have to listen to you. We don’t need to put up with people like you! You need to leave the stadium.” In which Reece replied “Yes you fucking do, you’re the referee supervisor!” I replied “No I don’t! You need to leave now!” Reece replied, “Yeah right and who’s going to make me? You?” I said “Not me. We just call the police.” And have you put out. Reece then smiled and said “Yeah good! Call the police. I’ve got a few mates who are coppers and they’ll help me put your head through that fucking window” (referring to the window in the referee’s room). I replied “We know a few coppers too.” I then told to leave and that he was reported for threatening me at that point he lowed his head and took a step towards me and attempted to head butt me. I said to him “You’re on report for attempting to strike the referee’s supervisor.” Reece then walked off with his girlfriend. As they were leaving he continued making abusive comments to me and the others and turned around to myself, and finished off by saying, “You’re all fucked!”
Description of Charges - clearly outline details of report and make sure the appropriate charges are described in the information below.*
Referees and Officials Details
Reporting Referee's Name*
Reporting Referee's Email Address*

(this is not shared with reported parties)
Reporting Referee's Mobile Number*
(this is not shared with reported parties)
First Name
Last Name
Umpire's Name / Non-reporting Referee*
First Name
Last Name*
Last Name
Name of Scorer #1 (optional)
First Name
Last Name*
Last Name
Name of Scorer #2 (optional)
First Name
Last Name*
Last Name
Confirmation and Submission
Signature*
Untitled*
- I confirm the information above is correct and it is my intention to report those listed above.

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