San Carlos
| # | Player | MIN | G | A | YC | RC | G1h | G2h | IN | OUT |
|---|---|---|---|---|---|---|---|---|---|---|
| Jorge Poltronieri Calvo SUB | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Edder Munguio Villegas D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Mario Bello Marchena D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Víctor Portuguéz Madrigal D | 45 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | ||
| Jason Dwein Scott Guevara D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Maikol Mora García D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Walter José Villalobos Arguedas MF | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Verny Scott Wilson MF | 90 | 1 | 0 | 0 | 0 | 1 | 0 | |||
| Gustavo Jiménez Boza MF | 80 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Juan Vicente Solís Brenes AT | 90 | 1 | 0 | 0 | 0 | 1 | 0 | |||
| Bryan Isaías Vega Chaves AT | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Johnny Gerardo Chávez Arias | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Alfonso Antonio Esquivel Durán SUB | 61 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | |
| Josué David Aguilar Solís SUB | 29 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Jorge Ramírez Villalobos SUB | 10 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | ||
| Cristian Antonio Chávez Chacón MF | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Dany Gabriel Carvajal Rodríguez SUB | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Rosbin Fernando Mayorga Jiménez AT | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Steven Sánchez Molina D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Totals | 1485 | 3 | 0 | 1 | 0 | 2 | 1 | 3 | 3 |
Goal scorers aren't recorded for every goal in this game (3 of 4 attributed).
Belen
| # | Player | MIN | G | A | YC | RC | G1h | G2h | IN | OUT |
|---|---|---|---|---|---|---|---|---|---|---|
| Anthony Jesús Vargas Gómez GK | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Aníbal Arrieta Leal D | 90 | 1 | 0 | 0 | 0 | 1 | 0 | |||
| Carlos Adrián Clark Cordero D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Ariel Eduardo Contreras Rodríguez D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Roberto Rojas Cortés D | 80 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Giancarlo Palacios Reyes D | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Olger Guzmán Murillo MF | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Allan Duarte Sánchez MF | 90 | 1 | 0 | 0 | 0 | 1 | 0 | |||
| Ronny Quesada MF | 53 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Andy Alexander Furtado Dixon AT | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Luis Ricardo Zumbado Rodríguez AT | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Vinicio Alvarado | 90 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Bryan Gerardo Beita Calderón SUB | 37 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Esteban José Chávez Vargas SUB | 10 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | ||
| Totals | 1080 | 2 | 0 | 0 | 0 | 2 | 0 | 2 | 2 |