Your Name *
Please enter your given name, as it would appear on your insurance card. IE Johnathan vs. John
Report Your Activity: This can include any of the following: Club Meetings, Club Activities, Individual activities - time spent doing club-related activity independently or with others, Social gatherings or informal meetings with other club members *
We were unable to locate your profile based on the email you provided - please provide the email you used when initially enrolling with Element3 Health.
If you have not yet registered with Element3 Health, please click here to register.
Please allow 48 hours after registering to report your activity through this page - if you would like to report your activity sooner, please send an email to email@example.com letting us know how many activities you participated in over the past six months.
This will take a few seconds to process
First Name must be filled out
Last Name must be filled out
Club Name must be filled out
Thank you for submitting your activity! To submit activity for another club, please click here.