Obverse: A nude boy with short cloak flying out from his shoulder, blowing on a torch held in his right hand. Legend: 'LATEAT SCINTILLVLA FORSAN'. Exergue: 'SOC . LOND . IN . RESVSCITAT . INTERMORTVORVM INSTIT . MDCCLXXIV'. Reverse: Within an oak wreath tied with ribbon, name of recipient and inscription. Inscription:'VIT . PERIC . EXPOS . D . D . SOC . REG . HVM'. [5 straight lines]. Inscription on edge: 'LIEUT. WALTER HAILSTONE R.N. 28 JUNE 1881'. [awarded for an unsuccessful attempt at saving life]. Suspended by a cusped bar from a dark blue ribbon.

Awarded to Lieutenant Walter Hailstone (1848-1913) for 'Gallant conduct in jumping overboard at sea after 2 men.'