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NEW YORK DENTAL NETWORK, LLC
Participation Agreement for Members

New York Dental Network, LLC has organized a dental plan for individuals, including
group members and seniors, age 62+, and all members of their respective households,
if applicable, to provide access to a quality dental program with reduced rates.
(The term "Member", as hereinafter used in this Agreement, shall be
deemed to include any eligible family or household members.) Each member has
entered into an Agreement with the plan to receive the benefits conferred by
membership in the plan.

THIS AGREEMENT is made and entered into by and between the undersigned member,
(hereinafter referred to as the "Member"), and NEW YORK DENTAL NETWORK,
LLC, (hereinafter referred to as "NYDN"), a New York Limited Liability
Company, incorporated under the laws of the State of New York and duly authorized
to do business in the State of New York.

1. PURPOSE OF AGREEMENT
The purpose of this agreement is to establish the terms and conditions under
which members have access to reduced network rates for dental services provided
by participating NYDN dentists as shown on NYDN’s website.

2. SCHEDULE OF RATES AND PROCEDURES
NYDN’s schedule of dental rates and procedures, as posted on NYDN website, is
subject to modification from time to time. The "Regional Fee" is representative
of the usual and customary fee (UCR) charged by private practice dentists in
the New York City Metro Area contacted by NYDN. “Network" fees are
the fees actually paid by NYDN members, subject to rate schedule footnotes regarding
fee variation and fee ranges. NYDN participating dentists agree to offer MEMBERS
the lower of the NYDN network fee or the dentist’s usual fee for services rendered.

3. PARTICIPATING PROVIDERS
The list of participating providers may change from time to time. NYDN’s objective
is to offer MEMBERS access to quality dental care providers at all times.

To locate a Provider, Members can view the list of Dentists posted on the NYDN
website or contact NYDN by phone. The Member is welcome to nominate any dentist
licensed in NY State, and NYDN will be glad to contact that dentist regarding
possible appointment as a NYDN participating dentist.

4. DENTISTS ELIGIBLE for NYDN Participation:
When considering eligibility of Dentists for participation in this plan, NYDN
reviews Licensing Information published by the New York State Department of
Education, Office of the Professions. This state agency establishes and enforces
professional standards and it licenses Dentists and certain other staff members
who may be working in dental offices. NYDN concerns itself with DENTIST credentials
and professional history. NYDN does not become involved with management, operation,
or personnel in participating dental offices.

Prior to enrollment of a dentist, NYDN verifies that the dentist is licensed
by the New York State Department of Education, Office of Professions. NYDN also
checks to ensure that no Disciplinary Action has been taken against the dentist
since January 1, 1994 (the earliest date to which this portion of the New York
State Office of Professions database refers). NYDN does not permit any dentist
with a history of disciplinary action, as shown on the New York Department of
Education website, to enroll as a participating dentist in the New York Dental
Network, and NYDN reviews information found on this website prior to the enrollment
of a DENTIST and periodically, thereafter. Members are encouraged to use this
or similar resources when selecting a dentist listed by the plan. LINKS to the
relevant information on the New York State Office of the Professions website
described above, are provided below:

http://www.op.nysed.gov/prof/dent/
(New York State Office of the Professions, Licensing, etc)

http://www.op.nysed.gov/opsearches.htm
(New York State Office of the Professions, Dentist License info.)

http://www.op.nysed.gov/opd/rasearch.htm
(New York State Office of the Professions, History of Disciplinary Action)

NYDN is not, in any way, involved in the practice of Dentistry or the operation
of Participating Dental offices. NYDN cannot be held responsible for any problems
or issues that may arise between our members and participating dentists, or
members of the Dentist’s office staff. Our role is limited to the enrollment
of duly licensed Dentists in the State of New York, and to post and support
data shown in our detailed schedules of Professional Rates and Procedures for
the benefit of our members and the mutual reference of our members and participating
dentists.

5. ENROLLMENT AND MEMBERSHIP
All MEMBERS enroll and pay their membership fees at the NYDN website. NYDN will
accept membership payment via PayPal and/or similar secure professional payment
gateway that is mutually agreed upon by NYDN and MEMBER. Payment modes will
be Annual, Semi-Annual, or Quarterly, as posted on enrollment portion of NYDN
website.

6. VERIFICATION of MEMBER Enrollment:
To be eligible for network Member reduced rates, the Member shall be required
to provide the Provider with his/her membership card or other proof of membership.
The Provider shall have the right to verify the MEMBER’s status in the
Network before offering Reduced Dental rates. Verification can be done at the
NYDN website or by phone.

7. SIX MONTH Trial Period: All first time members of NYDN will be given a SIX
MONTH trial period during which they are encouraged to use all plan services.
Cost for the trial period is $1.00, and this amount will be refunded during
the trial period if the member wishes to cancel membership, for any reason.
Convenient LINKS for membership cancellation will be posted on the NYDN website,
and will be included in regular emails sent to NYDN members. The SIX MONTH trial
period is not available to returning MEMBERS.

At the end of the SIX MONTH trial period, if the member elects to continue
membership, regular membership rates, as established upon enrollment and posted
on NYDN website, will apply.

8. ALL MEMBERSHIP PAYMENTS will be processed via automatic and recurring payment
mode. Member authorizes automatic and recurring payments to NYDN via PayPal
or similar secure professional payment gateway to which both NYDN and the member
agree. Member may STOP membership and payment at any time, with no further membership
obligation, by notifying NYDN by phone or via the LINKS mentioned in this agreement.
Member may also stop automated recurring membership payments by contacting PayPal
or similar automated payment gateway being used by NYDN to process membership
payments.

Membership in NYDN shall terminate in the event that membership payment is
not received by NYDN on a timely basis.

9. BEYOND THE SIX MONTH trial period, all regular membership fees will be
paid by member via prearranged automatic and recurring membership payments processed
by PayPal and/or similar secure, professional payment gateway agreed upon mutually
by NYDN and MEMBER.

10. NYDN offers THREE CATEGORIES of MEMBERSHIP with same fee structure. Special
features or benefits may apply to Group Members and Senior 62+ Members. NYDN
will notify members in these categories as special features or benefits may
become available.

A. Regular Membership: Open to all individuals and families. Rates shown will
be for Single Membership or Family Membership, which includes all household
members.

B. Group Membership: Open to all Corporations, Partnerships, LLC’s, Sole-Proprietors,
and Government, Religious, and Fraternal Organizations. Special features or
benefits that may apply to group membership will be posted, if applicable, on
our website.

C. Senior 62+ Membership: Open to all households that include at least (1) member
who is age 62+ or older. Special features or benefits that may apply to Senior
62+ membership will be posted, if applicable, on our website.

10. INDEPENDENT ORGANIZATION:
NYDN is an independent organization that does not practice dentistry. All professional
and financial arrangements for dental services are between MEMBER, acting as
an individual and NYDN participating dentist, acting as an independent professional.
NYDN does not become involved, beyond posting the schedule of dental rates and
procedures published on the NYDN website, with professional fees, services,
or payment for same. NYDN participating dentists agree to offer MEMBERS the
lower of the NYDN network fee or the dentist’s usual fee for services rendered.

NYDN shall endeavor to manage and update the list of Network Dental Providers.
A list of Providers will be posted on the NYDN website and members may request
updates or clarification of the provider list at any time by phone or email.

It is understood and agreed that this Agreement shall not be interpreted as
creating any partnership or joint venture relationship by, between or among
NYDN, the Providers, the Members or personnel providing Dental Services on behalf
of Providers.

11. REDUCED RATES for dental services provided pursuant to this agreement do
not constitute any form of dental or health insurance, and NYDN is not regulated
by any governmental insurance department or agency. It is understood and agreed
that this agreement shall not be interpreted as creating any insurance relationship
by, between or among the NYDN, the Providers, the Members, or personnel providing
Dental Services on behalf of the Providers.

12. The DENTAL SERVICE PROVIDERS shall be solely responsible for billing and
collecting payment from the MEMBERS in connection with the Dental Services.
NYDN shall not have any role whatsoever in underwriting, collecting charges,
adjusting, or settling claims among MEMBERS or the Providers in connection with
Dental Services.

13. HOLD HARMLESS: MEMBER will indemnify and hold NYDN harmless for any legal
action, injury and/or loss, real or perceived arising out of his/her membership
in NYDN, including but not limited to the professional services received from
NYDN participating dentists. 14. MEMBER HEREBY RELEASES, WAIVES, DISCHARGES,
AND COVENANTS NOT TO SUE NYDN and all branches thereof, its directors, officers,
employees, and agents from all liability to MEMBER, his/her personal representatives,
assigns, heirs, and next of kin for any loss or damages, and any claim or demands
therefor on account of injury to the person or property or resulting in death
of MEMBER, whether caused by the negligence of NYDN or otherwise while MEMBER
is receiving professional services or care from any DENTIST affiliated with
NYDN.

THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER,
INDEMNITY, and HOLD HARMLESS AGREEMENT is intended to be as broad and inclusive
as is permitted by the law of the State of New York and that if any portion
thereof is held invalid, it is agreed that the balance shall, notwithstanding
continue in full legal force and effect.

15. COMMUNICATION: MEMBER authorizes NYDN to communicate periodically with
MEMBER via fax, phone, U.S. mail, e-mail or other conventional communication
means to perform NYDN administrative functions and to notify member of changes,
options or promotional information related strictly to NYDN. Member authorizes
NYDN to communicate with participating dentist office regarding membership status
verification. NYDN never collects or distributes confidential member medical
information for any reason.

16. ASSIGNMENT: This AGREEMENT is intended to provide reduced rate dental services
to the MEMBER and household members, if enrolled in family plan, and cannot
be assigned or transferred by MEMBER to anyone.

17. WAIVER: A waiver of any breach of this AGREEMENT or of any of the terms
or conditions by either party shall not be deemed a waiver of any repetition
of such breach or in any way affect any other terms or conditions. No waiver
shall be valid or binding unless it is in writing and signed by the parties.

18. NOTICES: All written notices shall be deemed to have been made at the
time of posting and shall be sent to the following addresses set forth below.

19. ENTIRE CONTRACT: This AGREEMENT embodies the entire understanding of the
parties and may be amended only in writing.

20. SEVERABILITY AND CHOICE OF LAW: If any one or more of the provisions of
this AGREEMENT should be found to be invalid, illegal or unenforceable in any
respect, the validity, legality and enforceability of the remaining provisions
shall not in any way be affected or impaired. The laws of the State of New York
shall govern this AGREEMENT.

20. ELECTRONIC SIGNATURE: MEMBER indicates his/her agreement with terms and
conditions of this document by electronic (I Agree) confirmation statement attached
hereunto. Electronic Signature Agreement confirms that by signing any agreement
on this site, he/she is signing the Agreement electronically. MEMBER agrees
his/her electronic signature is the legal equivalent of his/her manual signature
on the Agreement. By signing the agreement, MEMBER consents to be legally bound
by the Agreement’s terms and conditions.