Official Protest Form printable pdf download

Connecticut Junior Soccer Association

Official Protest Form

(Excluding Cup Finals*)

Protest Procedure: Every protest must be made in writing and must contain the particulars of the grounds on which

it is based. Two (2) copies of the protest must be lodged with the protest committee in charge accompanied by the

application protest fee of $300.00. The protest must be lodged with the committee, and a copy of the protest sent to

the opposing team, within three days (i.e. 72 hours) of the conclusion of the match to which it relates. The

committee shall act and make a decision on the protest within 72 hours after receipt of the protest. The protest fee

will be refunded if the protest is upheld otherwise the protest fee is non-refundable.

In the event of a CT Cup or State Cup game other than the final, the protest time is reduced to 48 hours and the

committee must act and make a decision within 48 hours after receipt of the protest. A faxed copy, of the protest

and check, to the Protest Committee or the CJSA Office and a faxed copy or written notice of the protest to the

opposing team will be adequate. The actual check must be received by a member of the protest committee before

the protest hearing is convened.

Date Submitted__________________________

Time Submitted______________________________

Date of Match___________________________

Location of Match____________________________

Division (league, cup)______________________

Age Group_________Male_______Female________

Clubs taking part ______________________________vs________________________________________

Must list Rule/Policy Violated______________________________________________________________

______________________________________________________________________________________

Violation Description____________________________________________________________________

______________________________________________________________________________________

Attach sheet for additional information, if needed.

Signature of person submitting Protest_______________________________________________________

Name Printed_____________________________

Club Affiliation______________________________

Address_______________________________________________________________________________

Home Telephone______________________________Work Telephone____________________________

Club President/Official Signature __________________________________________________________

The Referee’s decisions “on points of fact connected with play shall be final, so far as the result of

Please Note:

the game is concerned” according to the F.I.F.A. rules and are not protestable.

CJSA Office

11 Executive Drive, Farmington CT 06032

Telephone # 860-676-1161 Fax # 860-676-1162

For office use only

Date Received_______________________

Time Received______________________________

Check Received: Yes check #____________

No___________

Decision of Protest Committee

Protest Upheld_________________

Reason____________________________________

Protest Denied_________________

Reason____________________________________

Date_________________________

Time______________________________________

Official Protest Form

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