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Acta arbitral
Fecha: ______________________________________ Lugar:________________________________________________________________________
Hora:___________________________________ Categoría:___________________________ Estadio:__________________________________
Arbitro:_____________________________________________________________________________________________________________________
Resultado final
Equipo:______________________________________________________________________________________________ ( ) Goles
Equipo:______________________________________________________________________________________________ ( ) Goles
Anotadores
Nombre del Jugador No. Cam. G Nombre del Jugador No. Cam. G
_________________________________________ _______________ ( ) _______________________________________ _____________ ( )
_________________________________________ _______________ ( ) _______________________________________ _____________ ( )
_________________________________________ _______________ ( ) _______________________________________ _____________ ( )
_________________________________________ _______________ ( ) _______________________________________ _____________ ( )
_________________________________________ _______________ ( ) _______________________________________ _____________ ( )
Sustituciones
Entra:__________________________Sale:________________________ Entra:_________________________ Sale:________________________
Entra:__________________________Sale:________________________ Entra:_________________________ Sale:________________________
Entra:__________________________Sale:________________________ Entra:_________________________ Sale:________________________
Entra:__________________________Sale:________________________ Entra:_________________________ Sale:________________________
Entra:__________________________Sale:________________________ Entra:_________________________ Sale:________________________
Amonestados
Equipo: _____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Equipo: _____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Expulsados
Equipo: _____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Equipo: _____________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Incidentes Eventuales
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
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Estado de Cancha
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_______________________________________________________________________________________________________________________________
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Pago de Tarjetas Amarillas (Q.5.00) y Rojas (Q.10.00)
Nombre del Jugador T. A/R Nombre del Jugador T. A/R
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________
_________________________________________ _______________ _______________________________________ _____________

Nota: No se retienen carnets y se adjunta:

Nómina de Juego de Equipos ( ) Dinero de Pago de Tarjetas ( )

Asistente No. 1 Arbitro Central Asistente No. 2

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