Are You Interested in Becoming an Elixicure Ambassador? Complete Form Below.

All approved ambassadors get a welcome gift basket with products and clothing as well as products sent out monthly.

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Athlete First Name
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Athlete Last Name
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Address
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Street Address 2
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City
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State / Province
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Postal / Zip Code
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Athlete Headshotupload
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Phone Numberyour full name
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Online Presence

We require a minimum online presence to consider athlete sponsorships, however we do occasionally make exceptions. Generally, we expect at least a reach of 5,000 or more across all your social media platforms.

Website URL
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Facebook Page URL
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Facebook following
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Twitter URL
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Twitter following
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Instagram URL
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Instagram following
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YouTube Channel (or N/A)
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How many YouTube subscribers?
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How many times are you willing to post on behalf of Elixicure per year?pick one!
Which of your social media pages has the highest following?pick one!
Sport Details
Choose Your Sportpick one!
At what level do you compete?pick one!
Have you placed 1st 2nd or 3rd in any competition associated with your sport within the past year?
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How often do you compete?
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Total number of spectators per year?
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Tell Us About Yourself
Briefly tell us a little about yourself, your experience with our products and why you are interested in being sponsored by Elixicure
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Who are your other sponsors (if any)?
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What's your shirt size?
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