Donor Registration Agreement

KidneyLife Foundation Inc. d/b/a "National Kidney Registry"

You must read this Registration Agreement before registering. If you do not accept or will not abide by this Agreement, please do not register.

1. Donor's Rights and Obligations
1. If you are a potential donor, you hereby affirm your intention to donate your kidney
2. You acknowledge that you will not be receiving any payment or consideration of any kind for your kidney.
3. You acknowledge that you are willing to travel to a Member Center for evaluation and surgery.
4. You acknowledge that there are absolutely no guarantees, express or implied whatsoever.
2. Your Warranties and Representations
1. You hereby represent and warrant that all of the information that you provide to The National Kidney Registry is true, complete, accurate, and current.
2. You hereby warrant that you are at least eighteen (18) years of age.
3. You warrant that you have the right, power, and authority to enter into this Agreement and to perform the acts required of you hereunder.
4. You acknowledge that you have read The National Kidney Registry's Privacy and Confidentiality Policy, as seen on the National Kidney Registry's website.
5. You acknowledge that The National Kidney Registry is not a health care provider, and is not responsible for any evaluation of the health of any donor or recipient, choice of treatment, or medical services rendered. The National Kidney Registry does not provide any medical services, nor make any medical determinations, nor does it endorse any particular health care or medical provider or procedure.
3. Authorization For Release of Health Information
1. You authorize The National Kidney Registry, under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and any other applicable federal, state, or local laws, to release any and all health or medical information regarding your care and treatment to any necessary parties. This authorization may include disclosure of information relating to drug and alcohol use and abuse, mental health treatment, and confidential HIV related information.
2. You understand that authorizing the disclosure of health information is voluntary and that any disclosure of this information carries with it the potential for an unauthorized further disclosure of this information by third parties, and that such further disclosure may not be protected under HIPAA.
3. You may revoke this authorization at any time in writing.
4. Miscellaneous Provisions
1. No promises or inducements have been made by either party to the other, except as expressly provided herein.
2. This agreement may be changed by the National Kidney Registry, at any time, without any notice to you, and go into effect upon posting the change on the website.
3. Neither this agreement nor any provision herein may be waived, amended, modified, canceled, terminated or otherwise changed or discharged by you.
4. If any provision of this agreement is held void or unenforceable, it shall not affect the enforceability of any other term or condition in this agreement, and shall not void any liability of any party to this agreement.
5. No breach of this agreement shall be deemed material unless the party alleging such a breach shall have given written notice of said breach to the other party, via certified mail, return receipt requested, and such other party fails to cure such breach within thirty (30) days, after receipt of said notice. Waiver of a breach of any provision of this agreement shall not be deemed or construed to be a waiver of any subsequent breach.
6. This agreement shall be construed in accordance with the Laws of New York State, and you hereby consent that any litigation shall be brought solely and exclusively in the Courts of the State of New York, in the United States of America.