Effective Date: March 2026

These Terms & Conditions (the “Terms”) are a legal agreement between you and Keystone CRNA LLC, a Washington limited liability company doing business as KeystoneCRNA (“KeystoneCRNA,” “we,” “us,” or “our”). They govern your use of keystonecrna.com, the KeystoneCRNA continuing education platform, educational programs, account features, gift card benefits, advocacy resources, Ether, and related services (collectively, the “Services”).

Please read these Terms carefully before creating an account or making a purchase. By selecting an unchecked box or button stating that you agree to these Terms, creating an account through a process that requires acceptance, purchasing a program, or otherwise affirmatively accepting these Terms, you agree to be bound by them.

If you do not agree to these Terms, do not create an account, purchase a program, or use the Services.

1. Eligibility

You must be at least 18 years old and legally able to enter into a binding agreement to use the Services.

KeystoneCRNA’s continuing education programs are designed primarily for Certified Registered Nurse Anesthetists (“CRNAs”) and other eligible professional users where expressly indicated. When you provide an AANA ID number or professional information, you represent that the information is accurate, current, and belongs to you.

KeystoneCRNA collects an AANA ID number for continuing education administration and reporting but does not independently verify a user’s identity, licensure, certification, membership, or authority to practice merely because an AANA ID number is submitted.

If you use the Services or make a purchase on behalf of an employer or other organization, you represent that you are authorized to do so and that your use complies with that organization’s policies.

2. Accounts and security

You must provide accurate and current information when creating and maintaining an account.

You are responsible for:

• safeguarding your login credentials;
• restricting access to your account;
• keeping your email address and other account information current; and
• promptly notifying KeystoneCRNA at support@keystonecrna.com if you suspect unauthorized access or use.

Accounts, purchased programs, assessments, certificates, and continuing education credits are personal to the registered user. You may not share, transfer, resell, or permit another person to use your account or obtain continuing education credit through it.

KeystoneCRNA may require verification of the email address associated with your account before allowing a purchase, changing account information, or providing access to certain features or benefits.

3. Electronic Communications and Delivery

You agree that KeystoneCRNA may provide account notices, receipts, course information, continuing education communications, security notices, and other transactional communications electronically, including through the Platform or at the email address associated with your account.

Eligible gift card rewards are delivered electronically by email through Tremendous to the email address associated with your account.

You are responsible for ensuring that your email address is accurate, accessible, and kept current. KeystoneCRNA is not responsible for a delay or failed delivery caused by an incorrect email address, loss of access to your email account, spam filtering, or another circumstance outside KeystoneCRNA’s reasonable control. We will, however, make reasonable efforts to help resolve a delivery problem that you report.

If you change your email address, KeystoneCRNA may require verification of the new address before issuing additional rewards or permitting certain account changes.

4. Continuing Education Programs

The number and type of continuing education credits available for a program, the applicable approval period, course requirements, and any material limitations will be displayed with the program information or course materials.

Continuing education credit is earned only after you satisfy all applicable requirements. Depending on the course, these may include reviewing educational content, meeting participation requirements, completing an assessment or post-test with the required score, completing an evaluation, making an attestation, or completing another stated activity.

You are responsible for confirming that a course or credit meets your individual certification, recertification, licensing, employer, or regulatory requirements. KeystoneCRNA does not guarantee that every course or credit will satisfy the requirements of every licensing authority, credentialing body, employer, or other organization.

KeystoneCRNA will identify courses approved for AANA credit as applicable. Approval information is course-specific and applies only for the stated approval period and number of credits.

5. Program access period

The access period for each program is displayed before purchase. Unless the applicable offer expressly states otherwise, the access period begins on the date of purchase.

You must complete educational content and course requirements within the applicable access period. Unused access does not automatically extend beyond the stated period.

KeystoneCRNA may update, revise, replace, or retire content when reasonably necessary to maintain accuracy, clinical relevance, approval requirements, legal compliance, security, or Platform functionality. We will not materially reduce the purchased access period, stated reward amount, or total continuing education opportunity without providing a reasonably comparable substitute or another appropriate remedy, except where a user’s access is suspended or terminated under these Terms.

6. Pricing, Payment, and Taxes Charged at Checkout

The price, access period, included features, available continuing education credits, and any included gift card benefit are displayed before purchase.

You authorize KeystoneCRNA and its payment processor, Stripe, to charge the payment method you provide for the total amount shown at checkout, including any taxes KeystoneCRNA is required to collect.

Prices, programs, and promotions may change for future purchases. A later change will not alter a completed purchase unless required by law or agreed to by you.

Promotional prices and discounts may have separate eligibility conditions or expiration dates. All KeystoneCRNA program purchases are one-time payments. KeystoneCRNA does not offer subscriptions, automatic renewals, or recurring charges and will not automatically rebill a saved payment card for program access.

7. Gift Card Benefits

Certain KeystoneCRNA program options include an electronic gift card benefit. The amount available for the selected program, any available retailer choices, and any allocation options will be displayed before purchase.

Gift card benefits are separate from continuing education credit and do not change the amount or type of credit earned.

Where offered, a standard gift card benefit may be divided among available retailers in the increments displayed by the Platform. AI Flex may allow a user to select from available gift card amounts in $400 increments, up to the maximum displayed for the selected program. The separate Keystone Advocacy Pledge reward, when offered, is governed by Section 11.

Gift card amounts, retailer choices, and allocation options may change for future purchases. KeystoneCRNA will not retroactively reduce the total gift card value stated for a completed purchase, except to correct an obvious pricing or technical error before fulfillment and only to the extent permitted by law.

Gift cards have no cash redemption value through KeystoneCRNA. This does not limit any cash-redemption right that may apply against the card issuer under applicable law.

8. Gift Card Trigger and Fulfillment

For a qualifying purchase, fulfillment of the standard gift card benefit begins only after both of the following conditions have been satisfied:

1. the user has completed the first lesson; and
2. seven days have passed since the purchase date.

If the first lesson is completed before seven days have passed, the reward will not be issued until the seven-day period has elapsed. If the first lesson is completed after that period has elapsed, fulfillment may begin after the lesson is completed. Users should review the refund rules in Section 10 before completing the first lesson.

Once fulfillment has been initiated, retailer selections and allocations generally cannot be changed, canceled, or reversed. Rewards are delivered by email through Tremendous to the email address associated with the user’s KeystoneCRNA account.

Delivery timing may vary depending on Tremendous and the selected retailer or card issuer. If a reward has not arrived within the timeframe displayed by the Platform or fulfillment communication, contact support@keystonecrna.com.

9. Gift Card Providers and Retailer Terms

KeystoneCRNA uses Tremendous and participating retailers or card issuers to administer and deliver gift card rewards. Tremendous delivers the reward electronically by email.

After a reward is issued, its use is subject to the lawful terms, redemption rules, expiration dates, fees, geographic restrictions, and availability requirements established by Tremendous, the selected retailer, or the card issuer. Applicable restrictions are shown by Tremendous during redemption and are not displayed on the KeystoneCRNA website before the user selects a reward. Users are responsible for reviewing the applicable provider, retailer, and issuer terms presented during redemption.

Retailer availability may change. If a selected retailer becomes unavailable before fulfillment, KeystoneCRNA may provide another retailer option or a reasonably comparable reward of the same stated value. KeystoneCRNA is not responsible for a third party’s outage, discontinuation, account restriction, or redemption decision outside KeystoneCRNA’s reasonable control, but this does not excuse KeystoneCRNA from delivering the reward value promised as part of a completed purchase.

10. Refunds

A purchase is eligible for a refund only under the refund rules disclosed at checkout and in this section. Unless applicable law requires otherwise, a purchase is not eligible for a refund after fulfillment of any standard gift card benefit associated with that purchase has been initiated.

As described in Section 8, reward fulfillment does not begin until the user has completed the first lesson and seven days have passed since purchase. A user who wants to request a refund must do so before reward fulfillment is initiated and must satisfy any other refund conditions disclosed at checkout and in this section. Redemption of the gift card is not required for the no-refund limitation to apply once fulfillment has been initiated.

Nothing in these Terms limits a refund, cancellation, chargeback, or other consumer right that cannot legally be waived. KeystoneCRNA may also issue a refund, credit, replacement, or other remedy when appropriate to correct a duplicate charge, material technical failure, failure to provide the purchased program, or another verified error.

Refund requests must be sent to support@keystonecrna.com from the email address associated with the account and should identify the purchase at issue.

11. Keystone Advocacy Pledge Reward

The Keystone Advocacy Pledge is an optional educational and professional-engagement feature. When offered with an eligible purchase, a user who completes the stated requirements may receive the additional gift card amount displayed with the offer.

The Advocacy Pledge reward is separate from any standard gift card benefit included with a purchased program. A user who purchases a program without a standard gift card may still be eligible for the Advocacy Pledge reward if the offer expressly says so.

Completing the activity identified by the Platform as the Advocacy Pledge reward trigger initiates fulfillment of that separate reward and may affect refund eligibility only as clearly disclosed before the activity is completed.

Participation is voluntary and is not required to earn continuing education credit for purchased educational courses unless the applicable course information expressly states otherwise.

The Advocacy Pledge does not require a political contribution, PAC contribution, vote, support for or opposition to any candidate or political party, or disclosure of a user’s political affiliation.

12. Employer reimbursement and accurate disclosure

Employer reimbursement policies vary. KeystoneCRNA does not guarantee that an employer, facility, health system, government entity, or other organization will reimburse any purchase.

You are solely responsible for:

• determining whether your employer permits reimbursement of a program that includes a gift card or other personal benefit;
• accurately describing the purchased program and included benefit;
• making any disclosure required by your employer’s reimbursement, ethics, conflict-of-interest, incentive, or expense policies; and
• repaying or addressing any amount your employer determines was not eligible for reimbursement.

KeystoneCRNA receipts and supporting documentation will accurately identify the transaction and will not be altered to conceal or mischaracterize an included gift card benefit. If you are uncertain about reimbursement, obtain written approval from your employer before purchasing or, at the latest, before completing any activity that triggers reward fulfillment.

KeystoneCRNA is not responsible for a reimbursement request that is denied, reversed, audited, recouped, or disputed by an employer.

13. Tax Treatment and Information Reporting

KeystoneCRNA treats both the standard gift card benefit included with a purchased program and the separate Keystone Advocacy Pledge reward offered in connection with an eligible purchase as purchase-related rebates or promotional benefits. These benefits are not treated as compensation for services performed by the purchaser.

Based on this treatment, KeystoneCRNA does not issue Form 1099-MISC or Form 1099-NEC solely in connection with either the standard gift card benefit or the Keystone Advocacy Pledge reward. KeystoneCRNA may request tax information or issue an applicable tax form if required by a change in law or by circumstances requiring different treatment.

KeystoneCRNA does not provide tax, accounting, or legal advice. Users are responsible for determining and satisfying any tax or reporting obligations applicable to their individual circumstances and should consult a qualified CPA or other tax professional for guidance.

14. Educational content disclaimer

KeystoneCRNA materials are provided for continuing professional education and informational purposes. Although KeystoneCRNA strives to provide evidence-informed, accurate, and clinically relevant content, medical knowledge, medications, devices, recommendations, standards, and professional guidance change over time.

The Services are not a substitute for independent clinical judgment, current prescribing information, institutional policies, applicable standards of care, or consultation with an appropriately qualified professional.

The Services do not establish a clinician-patient relationship. You remain responsible for your own professional decisions, clinical practice, and patient care.

15. Ether and artificial intelligence features 

Certain programs may include access to Ether, KeystoneCRNA’s educational AI assistant. Ether is designed to answer questions relating to KeystoneCRNA course content and is not intended to function as a general-purpose assistant.

AI-generated responses may be incomplete, inaccurate, outdated, or otherwise incorrect. You must independently evaluate and verify clinically significant information using the underlying course materials and appropriate authoritative sources.

Ether does not provide medical advice, patient-specific guidance, emergency assistance, diagnosis, treatment recommendations, or a substitute for professional judgment. Do not use Ether for real-time clinical decision-making.

Do not submit protected health information (“PHI”), patient identifiers, personally identifiable patient information, confidential employer information, or other confidential third-party information to Ether.

KeystoneCRNA may apply reasonable usage limits, rate limits, or security restrictions to AI features. Any material usage limit applicable to a purchased program should be disclosed with that program. AI access and unused usage capacity have no cash value and may not be transferred.

16. Intellectual property and limited license

KeystoneCRNA and its licensors own the educational materials, written and audio content, graphics, assessments, software, branding, compilations, course structure, and other content made available through the Services, except where third-party ownership is identified.

Subject to these Terms, purchasing a program grants you a limited, personal, revocable, nonexclusive, nontransferable license to access and use the included materials for your own professional education during the applicable access period.

You may not, without prior written permission:

• reproduce, distribute, sell, sublicense, publish, upload, publicly display, or share KeystoneCRNA content;
• record or systematically download audio, lessons, assessments, or other materials;
• scrape or extract content or data using automated means;
• remove copyright, trademark, or proprietary notices;
• use KeystoneCRNA content to develop, train, evaluate, or improve an AI model or competing educational product; or
• create or sell a derivative commercial product based on KeystoneCRNA content.

Nothing in these Terms restricts a right granted by law that cannot be waived, including applicable fair-use rights.

17. Acceptable use

You agree not to:

• share your account or allow another person to use it;
• complete coursework, assessments, evaluations, or attestations for another person;
• allow another person to obtain continuing education credit through your account;
• submit false professional, identity, completion, reimbursement, or reward information;
• manipulate or attempt to manipulate assessments, certificates, gift card eligibility, Advocacy Pledge rewards, or fulfillment;
• use automated tools to scrape, copy, download, or reproduce protected content;
• probe, disrupt, circumvent, or interfere with Platform security, access controls, usage limits, or operation;
• introduce malicious code or use the Services to harm another person or system;
• submit PHI or identifiable patient information where prohibited by these Terms; or
• use the Services for unlawful, fraudulent, deceptive, or abusive purposes.

KeystoneCRNA may investigate suspected misuse and take proportionate action under Section 24.

18. Assessments, attestations, certificates, and credit reporting

You must personally complete all required educational activities and assessments. By submitting a post-test, evaluation, attestation, or other completion requirement, you represent that you personally completed the applicable activity and that the information submitted is accurate.

KeystoneCRNA may withhold, correct, or revoke a certificate or credit record when reasonably necessary to address fraud, account sharing, a material technical or administrative error, inaccurate completion information, or an applicable AANA requirement. When practicable and legally permitted, KeystoneCRNA will notify the affected user and provide an opportunity to correct an error or explain the circumstances.

KeystoneCRNA reports eligible completed credits to AANA in accordance with applicable program requirements. Timing and data practices are described in the KeystoneCRNA Privacy Policy.

KeystoneCRNA strives to maintain reliable access to its platform but does not guarantee uninterrupted or error-free operation.

The platform may occasionally be unavailable due to maintenance, upgrades, technical problems, security concerns, or circumstances outside KeystoneCRNA's control.

When reasonably appropriate, KeystoneCRNA may provide additional access time when a significant platform outage materially prevents users from accessing purchased educational content.

19. Third-Party Services and Links

KeystoneCRNA uses third parties for services such as payment processing, gift card fulfillment, hosting, communications, analytics, and AI functionality. Your direct interaction with a third-party service may also be governed by that provider’s terms and privacy policy.

KeystoneCRNA is not responsible for a third-party outage, delay, restriction, or failure outside KeystoneCRNA’s reasonable control. However, KeystoneCRNA remains responsible for its own obligations under a completed purchase and will provide a reasonable remedy when a third-party failure materially prevents delivery of a purchased program or promised benefit.

Links to third-party websites are provided for convenience or educational reference and do not necessarily constitute endorsement.

20. Availability and Platform Interruptions

KeystoneCRNA strives to maintain reliable access but does not guarantee uninterrupted or error-free operation. The Services may be temporarily unavailable because of maintenance, upgrades, technical problems, security concerns, third-party failures, or circumstances outside KeystoneCRNA’s reasonable control.

If a significant outage within KeystoneCRNA’s control materially prevents access to paid content, KeystoneCRNA may provide additional access time, restored access, a replacement, a credit, or another reasonable remedy based on the circumstances.

You are responsible for completing time-sensitive course requirements sufficiently before your access period or an external certification deadline. KeystoneCRNA is not responsible for a missed external deadline caused by delay that the user could reasonably have avoided, but this does not limit rights that cannot legally be waived.

21. Privacy

KeystoneCRNA’s collection, use, and disclosure of personal information are described in the KeystoneCRNA Privacy Policy, which is incorporated into these Terms by reference.

The Privacy Policy is a notice of KeystoneCRNA’s data practices. Where applicable law requires separate consent for a particular data practice, acceptance of these Terms alone does not replace that required consent.

22. Changes to programs, features, and vendors

KeystoneCRNA may change future prices, educational offerings, reward options, retailers, Platform features, AI functionality, or other Services.

For an existing purchase, KeystoneCRNA may make reasonable changes needed for accuracy, security, legal compliance, AANA requirements, vendor availability, fraud prevention, or Platform operation. KeystoneCRNA will not retroactively reduce the material access, continuing education opportunity, or stated reward value promised for a completed purchase without providing a reasonably comparable substitute or other appropriate remedy, except where access is suspended or terminated for the user’s violation of these Terms.

If a course can no longer be offered or approved credit can no longer be provided, KeystoneCRNA may substitute a reasonably comparable course or provide an appropriate refund or credit for the affected portion of the purchase.

23. Disclaimer of warranties

To the fullest extent permitted by law, the Services are provided on an “as is” and “as available” basis. KeystoneCRNA does not warrant that the Services will be uninterrupted, error-free, free of harmful components, or suitable for every professional circumstance.

KeystoneCRNA does not warrant that every licensing authority, credentialing organization, employer, or reimbursement program will accept a course, credit, purchase, receipt, or included reward.

Nothing in these Terms excludes an express warranty made at checkout or a warranty, remedy, or consumer protection that cannot legally be excluded.

KeystoneCRNA may suspend or terminate access when reasonably necessary because of fraud, unauthorized account sharing, misuse of CE credentials, manipulation of gift card benefits, security threats, nonpayment, or material violation of these Terms.

Termination for misconduct does not create a right to a refund where a refund would otherwise be unavailable under these Terms.

24. Suspension and Termination

KeystoneCRNA may limit, suspend, or terminate access when reasonably necessary to address:

• fraud or attempted fraud;
• unauthorized account sharing;
• false completion or professional information;
• manipulation of assessments, certificates, rewards, or fulfillment;
• a security threat or misuse of the Platform;
• nonpayment or a reversed payment; or
• another material violation of these Terms.

When reasonable under the circumstances, KeystoneCRNA will provide notice and an opportunity to correct the issue. Immediate action may be taken where needed to prevent fraud, protect security, preserve accreditation integrity, or comply with law.

Termination for substantiated misconduct does not create a right to a refund that would otherwise be unavailable. KeystoneCRNA may withhold an unissued reward obtained through fraud or manipulation. Any correction to earned continuing education credit or certificates will be handled under Section 18 and applicable AANA requirements.

You may stop using the Services at any time. Ending use or requesting account deletion does not itself create a refund right or require deletion of records KeystoneCRNA must retain for continuing education, accounting, fraud-prevention, tax, dispute, or legal purposes.

25.Limitation of Liability

To the fullest extent permitted by law, KeystoneCRNA and its members, officers, employees, and agents will not be liable for indirect, incidental, special, exemplary, punitive, or consequential damages, or for lost profits, lost business opportunities, or loss of data, arising from or relating to the Services.

To the fullest extent permitted by law, KeystoneCRNA’s total liability for all claims arising from or relating to a purchased program will not exceed the amount you paid KeystoneCRNA for the program giving rise to the claim.

These limitations do not apply to KeystoneCRNA’s fraud, willful misconduct, gross negligence, or any liability or remedy that cannot legally be limited. They also do not eliminate KeystoneCRNA’s obligation to provide the continuing education access or gift card value expressly promised as part of a completed purchase, subject to the other provisions of these Terms.

Some jurisdictions do not permit certain exclusions or limitations, so portions of this section may not apply to you.

26. Governing Law and Disputes

These Terms are governed by the laws of the State of Washington, without regard to conflict-of-law principles, except where the law of another jurisdiction must apply and cannot be waived.

Before filing a formal claim, you and KeystoneCRNA agree to make a good-faith effort to resolve the dispute informally. To begin that process, email support@keystonecrna.com with your name, account email, a description of the issue, and the relief requested. This informal process does not require either party to miss a filing deadline or waive a right that cannot legally be waived.

These Terms do not currently require arbitration and do not waive participation in a class action. Any decision to add mandatory arbitration, a class-action waiver, or a specific court venue should be reviewed by qualified legal counsel and should not be added solely as a website-development choice.

27. Changes to These Terms

KeystoneCRNA may update these Terms to reflect changes in the Services, business practices, technology, or law.

The Terms in effect when a purchase is completed will generally govern that purchase. A later update will apply prospectively and will not retroactively reduce material purchased benefits or impose a materially different dispute process unless required by law or affirmatively accepted by the affected user.

If a change materially affects an active account or purchased program, KeystoneCRNA will provide notice through the Platform, by email, or by another appropriate method. The “Last Updated” date identifies the most recent version.

28. General Terms

Entire Agreement and Order of Precedence

These Terms, the Privacy Policy, and the program-specific terms displayed at checkout constitute the agreement between you and KeystoneCRNA regarding the Services. If program-specific terms displayed at checkout conflict with these general Terms, the program-specific terms control for that purchase to the extent of the conflict.

Severability

If any provision of these Terms is held unenforceable, it will be enforced to the maximum extent permitted, and the remaining provisions will remain in effect.

No Waiver

Failure to enforce a provision of these Terms is not a waiver of the right to enforce it later.

Assignment

You may not assign or transfer your account, purchased access, certificates, credits, or rights under these Terms. KeystoneCRNA may assign these Terms as part of a merger, acquisition, reorganization, financing, or sale of all or substantially all relevant business assets, subject to applicable law and the Privacy Policy.

Events Outside Reasonable Control

Neither party is responsible for delay caused by events outside its reasonable control, but this provision does not eliminate payment, refund, replacement, access-extension, or reward obligations that remain reasonably capable of performance.

Headings

Section headings are for convenience and do not change the meaning of these Terms.

29. Contact Information

Questions, support requests, or notices regarding these Terms may be directed to:

Keystone CRNA LLC
Washington, United States
support@keystonecrna.com

Acknowledgment

By affirmatively accepting these Terms, you acknowledge that you have read and agreed to them, including the provisions addressing:

• the personal nature of accounts and continuing education credit;
• program access periods and completion requirements;
• the two conditions that trigger gift card fulfillment;
• the effect of reward fulfillment on refund eligibility;
• employer reimbursement and accurate disclosure responsibilities;
• the limitations and appropriate use of Ether; and
• warranty and liability limitations.