Name your Brave 
Nomination Form

By submitting this form, I understand that I am nominating the person named above as part of The Barry Martin Foundation’s Name Your Brave campaign.

I understand that my nomination may be considered for inclusion in Edition Two of Barry the Brave. Submitting a nomination does not constitute consent for publication.

If a nomination is being considered for inclusion in the book or other Foundation materials, The Barry Martin Foundation will make contact and obtain any necessary permissions before identifiable information is published.

If the person I am nominating is under 18, I understand that submitting their nomination does not give permission for their name, image, story or other identifying information to be published. Appropriate consent from their parent or legal guardian will be obtained separately before any identifiable information about a child is published.

I confirm that the information I have provided is true to the best of my knowledge and I am happy for The Barry Martin Foundation to contact me about my nomination.

Information submitted privately through this form will not be published without further contact and any necessary consent.