Liability Form Upon submission, you will receive a copy of this form in the email you provide. A copy will be emailed to your local association’s secretary, as well as the executive secretary. Person Submitting Form *Email Address *Game InformationDate of Event *Level of Play *SelectBoys VarsityBoys JVBoys ModifiedGirls Flag VarsityGirls Flag JVYouthHome Team *Away Team *Weather Conditions *Conditions of Field *Officials InformationSelect Chapter *SelectAdirondackCapital DistrictCentral HudsonChamplainElmiraFinger LakesLong IslandMohawk ValleyPSALRochesterSouthern TierSouthwesternSuffolkSt. LawrenceSyracuseTri ValleyWatertownWestchesterWestern NYReferee *UmpireHead LinesmanLine JudgeBack JudgeField JudgeSide JudgePlayer InformationPlayer Name *Select *TeamHomeAwayDescription of Incident *Send Message