Nominate a Champion

 

 

 

 

 

Do you know someone that has received care at Riley Hospital within the last three years that should be a Riley Champion? Nominate them and tell us why. Nominees should be between the ages of 8-18 as these Riley ambassadors will be asked to publicly share their stories. Selected Riley Champions are notified in September. Please complete the form below and submit it to Riley Children’s Foundation.

Riley Champion Nomination Form
Parent's/Legal Guardian's Information
Nominated By:
About the Nominee:

* How does this nominee and family inspire others in the community?

* What was the nominee's injury or illness?

* What does this nominee do within his/her community to give back? How have they used their experience to make a difference? (i.e. do they share their story, volunteer, participate in Riley events such as the Radiothon, Kids Caring & Sharing, Dance Marathon, etc.?

* Please describe how this nominee embodies the spirit of a champion?

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