A Confederation medallion is used by the Deathly Regiment of the Elect within the American Wizarding Confederation to fulfill their side of the bargain made with the Generous Ones to retain control over the Lands Below. Every seven years, a human wizarding child is sent to the Lands Below, where he or she is conferred to the Gift-Place and sacrificed to the Lands Beyond.
The medallion is a metal disk stamped with the seal of the Confederation.
In May of 2010, Darla Dearborn attempted to force Innocence Pritchard to serve as the sacrifice, but Alexandra Quick intervened before the exchange could be made. Dearborn herself later carried the medallion through the Veil in the subterranean chamber below Charmbridge Academy, seemingly satisfying the terms of the bargain.