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Page 2


Dear Parents

This is the Cells4Life tissue collection, testing and storage agreement and it is a legaldocument. We request that you read it very carefully as it sets out the entire agreementbetween us. All of your information will be held in strict confidence.

For your reference, this document is divided into the following parts:

SECTION 1 CUSTOMER INFORMATION

SECTION 2 TISSUE STORAGE PRICE PLANS

SECTION 3 TISSUE COLLECTION, TESTING AND STORAGE AGREEMENT

SECTION 4 PAYMENT METHODS

Using block capitals please fully complete Sections 1 to 4 and return one agreement to uskeeping the other for your own records. You are also required to complete and return theConsent Booklet.

If you have any questions please do not hesitate to contact us.

Yours faithfully

Wayne M ChannonChairman

Page 3


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Section 1

Mother’s details:

Mother’s name: ____________________________________________ (“Mother”)Date of birth: _______________________________________________________Mother’s address: _______________________________________________________

_____________________________ Postcode _________________

Country: _____________________________

Home telephone: _____________________________

Mobile telephone: _____________________________

Work telephone: _____________________________

Fax: _____________________________

Email address: _______________________________________________________

Father’s details:

Father’s name: ____________________________________________ (“Father”)Father’s address: _______________________________________________________

(if different) _______________________________________________________

_____________________________ Postcode _________________

Country: _____________________________

Home telephone: _____________________________

Mobile telephone: _____________________________

Work telephone: _____________________________

Fax: _____________________________

Email address: _______________________________________________________

Birth details:

Name of procuring organisation: ________________________________________Name of procurer: ________________________________________Estimated delivery date: ________________________________________Name of delivering hospital: ________________________________________Name of midwife: ________________________________________Name of obstetrician: ________________________________________


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Section 2Both the Premium Storage Plan and the Annual Storage Plan include the industry leadingCells4Life package:

The Cells4Life collection kit Maternal blood testingMaternal blood collection kit Test results certificateCourier service Access to advice from a medicalViability testing professionalCord blood sterility testing

Each plan requires an initial deposit, payable upon booking. The remaining balance isdue upon successful storage of your Child’s cord blood and/or tissue. For furtherinformation about our Payment Plans, please contact us on +357 24727776.

Premium Storage PlanThis includes the first 25 years of storage. Thereafter there is an annualStorage Fee.

Single birth !1.995This comprises a deposit of !395 and a Storage Fee of !350.

Twins birth !2.795This is a discount of !800 to help towards the cost of having twins.This comprises a deposit !790 and a Storage Fee of !575.

Annual Storage PlanThis includes the first year of storage, thereafter there is an annualStorage Fee of !751 per child.

Single birth !1.295This comprises a deposit of !395.

!wins birth !1.865This is a discount of !725 to help towards the cost of having twins.This comprises a deposit !790.

Options+Cord Premium Storage Plan !630This includes an additional deposit increase of !75 and a balance increaseof !555 per Child.

+Cord Annual Storage Plan !0There is an annual Storage Fee of !751 per Child, payable after the firstyear’s storage.

Existing Cells4Life customers -!250As a token of our appreciation for making Cells4Life your preferred tissuestorage company, we offer you a discount of !250 to be deducted fromthe balance for each child after your first.

Total to pay ______________

All deposits are non-refundable1 Subject to annual review with a minimum term of 10 years.In the event that only the cord tissue can be stored, a one off fee of !860 is payable.


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This Agreement is between:(INSERT FULL NAME of Mother)

____________________________________________________________________

Date of Birth (of Mother) ______________________________________________

of (address)_________________________________________________________

___________________________________________________________________(referred to in this Agreement as “Customer” or “you”)

ANDCells4Life Group LLP (Company number OC 357135), whose registered office is at Units 2 & 3 Oak House,Woodlands Office Park, Albert Drive, Burgess Hill, RH15 9TN (referred to in this Agreement as “Cells4Life”,“we” or “us”).The terms and conditions contained within this Agreement together with the Consent Form form a legallybinding agreement between us which relates to the procurement, distribution, import, export, testing,processing, storage and cryopreservation of the Umbilical Cord and/or Placental Cord Blood of yourchild(ren) and your maternal blood sample. In signing this Agreement, you acknowledge and agree thatCells4Life is in no way providing medical advice, care or treatment to you or anyone else.

1. General terms1.1. “Cord Blood” means the umbilical and/or placental cord blood together with any stem cells.1.2. “Child” refers to your child who is due on the Expected Delivery Date as notified to us and in

relation to whose umbilical cord blood we are supplying you with a collection kit.1.3. “Consent Booklet” means the document which details the Cells4Life service as provided with

this Agreement and which records your consent to the service particulars.1.4. “Deposit” means the deposit as detailed in the “Stem cell storage price plans” section set out

in Section 2 to this Agreement.1.5. “Storage Fees” means the fees as detailed in the “Stem cell storage price plans” section set

out in Section 2 to this Agreement.1.6. “Third Party Costs” means the cost of the collection kit, laboratory fees, any applicable courier

fees and any applicable charges made by medical practitioners for procuring the cord blood.1.7 “Tissue Sample” means the umbilical cord tissue sample together with any stem cells.1.8 “+Cord Service” means the collection of a Tissue Sample in addition to Cord Blood.1.9 The +Cord Service is optional and additional to the collection and storage of Cord Blood (“the

Main Service”). A Customer may choose to receive the +Cord Service only after agreeing to theMain Service. The +Cord Service is not available to any Customer who does not purchase theMain Service.

1.10 In the event that the Cord Blood is not viable for storage but the Tissue Sample is, Cells4Lifewill store the Tissue Sample notwithstanding clause 1.9. In the event that only the TissueSample is stored, an additional charge of £1032 shall apply.

1.11 Where the +Cord Service is purchased the term Cord Blood shall in all subsequent clauses inthis Agreement include the Tissue Sample.

2. Your instructions2.1. Until the Child reaches the age of 18 we will act upon the written instructions of you or your

personal representatives in relation to the storage and use of the Cord Blood. When the Childreaches the age of 18 we are required to act upon the instructions of the Child in relation tothe further storage and use of the Cord Blood. However, please note that this Agreement isbetween you and us and you remain liable for the payment of any fees which arise under theterms of this Agreement for the duration of the term of this Agreement.

2.2. Except where this Agreement is terminated in accordance with clause 12.3 the Cord Blood shallat all times remain the absolute and sole property of the Child and Cells4Life holds the CordBlood on the terms set out in this Agreement.

3. Supply of collection kit3.1. We will send the collection kit to you once you have sent us the following:

3.1.1. A signed copy of this Agreement;3.1.2. the Deposit;

Section 3This document is important and you will be legally bound by it.Please read it carefully, seek legal and medical advice and letus know if you have any questions before signing.


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3.1.3. A correctly completed and signed Consent Booklet.3.2. If you are expecting more than one Child, you must notify us and pay the Deposit (detailed in

Section 2) for each child for whom you want Cord Blood to be stored by us. A separate collectionkit must be used for each Child and we will send you the number of collection kits you haverequested and paid for as detailed in the “Stem cell storage price plans” section.

3.3. We will endeavour to send the collection kit to all Cyprus addresses within seven (7) working days ofreceipt of this Agreement and the Deposit.

3.4. We do not guarantee any time for delivery of the collection kit and cannot accept responsibility forany delays in delivery which are beyond our control. If you have not received your collection kitwithin fourteen (14) days, please notify us and we will investigate.

3.5. In the event that you require a collection kit to be sent to you by courier you are responsible forpaying to us the courier costs.

3.6. We will send the collection kit to the address specified by you at the end of this Agreement.3.7. If you notice any fault with the collection kit, please return it to us and we will arrange for a

replacement collection kit to be sent to you and we will refund your reasonable postage costs forthe return of the collection kit to us.

3.8. If you have been sent the wrong number of collection kits, you must contact us as soon as possible.We will then arrange to send you an additional collection kit.

3.9. The collection kit is only to be used in respect of the Child due on the expected delivery date asnotified to us. The collection kit is uniquely bar coded to refer to you and your Child and must notbe used by or for any other person or any other child. If you do not use this collection kit for theChild then you must not use this collection kit for any other child unless this has been specificallyagreed with us in writing.

4. Procurement of cord blood4.1. It is a regulatory requirement that the procurement of Cord Blood using a Cells4Life collection kit must be

carried out by an appropriately qualified and authorised person. Further details relating to this can befound in the Consent Booklet and Cells4Life is happy to advise you further on this. Procurement of CordBlood by a person that is not properly qualified and authorised is a breach of the Human Tissue(Quality and Safety for Human Application) Regulations 2007. Further you should be aware that theviability of the Cord Blood may be affected if it is not procured by an appropriately qualified andauthorised person in accordance with our cord blood collection protocol. Cells4Life reserves the right torefuse to store Cord Blood which it believes has not been procured in accordance with its bloodcollection protocol.

4.2. Cells4Life does not directly employ any appropriately qualified and authorised phlebotomists or otherpersonnel to procure Cord Blood samples.

4.3. In the event that your medical practitioner refuses or is unable to proceed with procuring the CordBlood you may cancel this agreement in accordance with the terms set out in Clause 11.

4.4. In the event that you decide not to proceed with the procurement of the Cord Blood you may cancelthis agreement in accordance with the terms set out in Clause 11.

4.5. Once the Cord Blood has been procured, it is your responsibility to ensure that the collection kit issigned to confirm that it is your Child’s Cord Blood contained in the collection kit. If you have morethan one Child and have more than one collection kit, you must clearly identify each Child on theirrespective collection kit.

4.6. Cells4Life shall not be liable to you in any way if it is unable to process Cord Blood due to a failureby you to carry out your obligations under this Clause 4.

5. Delivery of cord blood to Cells4Life5.1. Once the Cord Blood has been procured, it is your responsibility to ensure that the collection kit is

handed directly to the courier and you must telephone Cells4Life’s twenty-four (24) hour collectionline to arrange for our courier to collect your collection kit.

5.2. You remain responsible for the collection kit until our courier collects it from you and youunderstand that the Cord Blood must be delivered to our laboratory in the UK within 48 hours.

5.3. Cells4Life shall not be liable to you in any way if it is unable to process Cord Blood due to a failureby you to carry out your obligations under this Clause 5.


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6. Minimum volumes and sample testing6.1. If in our opinion either

6.1.1. the volume of Cord Blood collected is too small; or6.1.2. the viability of Cord Blood collected is too low to be suitable for cryopreservation of the

stem cells we will contact you to discuss your wishes regarding processing and storage ofthe Cord Blood. If you decide to proceed with the storage, we cannot give you anyguarantee that there will be sufficient volume if the Cord Blood is required in the futureand you acknowledge this if you ask us to proceed.

6.2. There is a risk that Cord Blood can be contaminated either prior to or during the procurementprocess. Contamination can affect the viability and the future suitability of the Cord Blood fortherapeutic use. Cells4Life will arrange for a sample of the Cord Blood to be tested for contaminantsby its designated laboratory and we will notify you of the results. If requested a copy of the resultscan also be sent to your Child’s general medical practitioner to be placed on your Child’s medicalrecords. Cells4Life will continue to store the Cord Blood in accordance with this Agreement even iftesting has shown it to be contaminated until we receive instructions from you to dispose of the Cord Blood.

6.3. A maternal blood sample must be provided within 7 days of procurement of the Cord Blood and willbe tested for disease markers as specified by current EC legislation as detailed in the Consent Form.The results of which will be notified to you and a copy will be provided to the Mothers’ generalmedical practitioner if requested by the mother.

6.4. In order to procure, process, test, store and cryopreserve the Cord Blood Cells4Life requires yourconsent as evidenced by the appropriately completed and signed Consent Form. As explained in theConsent Information Booklet you may feel unable to consent to all the procedures set out on theConsent Form or alternatively you may at any point withdraw your consent to some or all of theseprocedures. As a result Cells4Life may not be able to carry out the necessary testing and procurementprocessing of the Cord Blood to enable it to store the Cord Blood successfully and in accordance withthe law. In this case Cells4Life will terminate the Agreement in accordance with Clause 12. Cells4Lifeis happy to discuss this with you further.

6.5. In the event that the Cord Blood collected is found to have been contaminated, and you acknowledgethat it may not be suitable for storage or any future use you authorise us to destroy the Cord Blood.In such circumstances, this Agreement will be cancelled and we will reimburse all of the fees alreadypaid by you to us as detailed in Section 2, excluding any Third Party Costs and the non-refundabledeposit.

7. Warranties7.1. We warrant to you that the services will be provided using reasonable care and skill and, provided

that you comply with your obligations, in accordance with this Agreement.7.2. You warrant to us that:

7.2.1. you are the parent/legal guardian of the Child with legal responsibility for the Child;7.2.2. you have the right to enter into this Agreement on behalf of your Child; and7.2.3. entering into this Agreement does not violate any local laws or regulations, as regards any

country where the Cord Blood is being drawn.7.3. IMPORTANT – You acknowledge and accept that we cannot give any guarantees with

respect to any:7.3.1. suitability of Cord Blood for the future treatment of diseases;7.3.2. successful treatment of diseases through Cord Blood transplantation;7.3.3. advantages of Cord Blood transplantation over other types of treatment using

stem cells; or7.3.4. successful transplantation of the Cord Blood; and you enter into this Agreement with

this understanding.

8. Limit of Cells4Life’s liabilityIMPORTANTSubject to the terms set out in this Clause our liability to you under the Terms of thisAgreement is as follows:

8.1. OUR LIABILITY TO YOU IN RESPECT OF ANY FAULT RELATING TO THE Collection Kit is limited to thecost of replacing the collection kit and/or reimbursing any Storage Fees paid by you.

8.2. Our liability to you in respect of ANY LOSS OR DAMAGE DUE TO OUR NEGLIGENCE, OR THENEGLIGENCE OF ANY OF OUR EMPLOYEES, shall be limited to DIRECT LOSSES YOU SUFFER WHICHWE COULD HAVE REASONABLY FORESEEN AT THE DATE OF THIS AGREEMENT UP TO THE MAXIMUMAMOUNT of one million pounds (£1million).

8.3. Nothing in this Agreement seeks to exclude our liability for the following:8.3.1. ANY DEATH OR PERSONAL INJURY CAUSED AS A DIRECT RESULT OF OUR

NEGLIGENCE,OR THE NEGLIGENCE OF OUR EMPLOYEES;8.3.2. Fraud or fraudulent misrepresentation.

8.4. We shall in no way be liable to you for any loss or damage suffered by you as a result of yourfailure to comply with the terms of this Agreement.


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11.1.2. '#6) *&(6*#7'&6) *$% "=$%µ& +-+9"(&6 '#6) (4#(&) 4.3 4 4.411.1.3. '#6) *&(6*#7'&6) *$% "=$%µ& +-+9"(&6 '#6) (4#(&) 6.1 4 6.511.1.4. -+ µ+) &-2µ&(7'&#& >(+*#7) µ"'+ '& #(6@-#+ (30) µ"(&)11.1.5. '& *&(1*#:'2 *$%:

+.*@B&6 -+ 0&6#$%(>&1 2 Cells4Life/.<6$(6'#&1 <6+=&6(6'#4)>.<6$(6'#&1 @#$µ$ >6+ -+ &*6#2(&1 #6) *&(6$%'1&) 4/5+6<.2 Cells4Life 5@-&6 &3&0$-#654 .%µ9:-1+ µ& #$%) *6'#:#") #2)

11.2. .& *&(1*#:'2 *$% +5%(7'&#& #$ *+(,- .%µ/,0+6$ %*, #$%) ,($%) #:- (2#(7- 11.1.1., 11.1.2.,5+6 11.1.3., 3+ '+) &*6'#("B$%µ& #+ ;"02 H*$345&%'2) µ&1:- #+ "?$<+ *$% "=&#& *02(7'&6 '&#(1#$ *(,':*$

11.3. .& *&(1*#:'2 *$% +5%(7'&#& #$ *+(,- .%µ/,0+6$ %*, #$%) ,($%) #2) (4#(+) 11.1.4. 3+ '+)&*6'#("B$%µ& ,0+ #+ =(4µ+#+ *$% "=&#& *02(7'&6 >6+ #2- +*$345&%'2 #$% <&1>µ+#$) '8µ9:-+ µ&#2 (4#(+ 2 #$% *+(,- .%µ/$0+1$% µ&1:- #+ "?$<+ *$% "=&#& *02(7'&6 '& #(1#$ µ"($)

11.4. .& *&(1*#:'2 *$% +*$9+'1'&#& -+ +5%(7'&#& #$ .%µ/,0+6$ '8µ9:-+ µ& #$%) ,($%) #:- (2#(7-11.1.4. 5+6 11.1.5. µ& #2- >(+*#4 <6+#+>4 '+) (4 #$% *+6<6$8 '+) &@- &1-+6 *@-: +*, 18 =(,-:-)2 Cells4Life 3+ 5+#+/@0&6 5@3& *($'*@3&6+ -+ '6>$%(&%#&1 ,#6 #$ +1µ+ #$% $µ9@06$% 07($% 3+µ&#+9&(3&1 '& @00$ *($µ23&%#4 #2) &*60$>4) '+) &9,'$- 2 &- 0,>: µ&#+9$(@ #2(&1 #$%)'=&#65$8) -,µ$%)


8.5. Subject to Clauses 8.1, 8.2 and 8.3 we exclude all other liability for damage or loss suffered inconnection with this Agreement whether direct or indirect to the maximum extent permittedby law.

8.6. You acknowledge and understand that we shall not be liable to you, or be considered to be inbreach of this Agreement, because of any delay in performing, or any failure to perform, anyof our obligations if the delay or failure was due to your acts or omissions or to any othercause beyond our reasonable control.

8.7. Should there be loss of the Cord Blood whilst in the care of Cells4Life, which was beyond ourcontrol, we will reimburse a proportion of the Storage Fee pre-paid (on a pro rata basis for theremaining storage term paid for).

8.8. You acknowledge that the Cord Blood collected will be divided into at least two separateportions. Both of these samples may be kept together at one location for some time untilbeing dispatched to a third party site. Therefore in the event of any loss or damage to theCord Blood for whatever reason it may not be possible to have a “back-up” sample.

9. Fees9.1. The Storage Fees are detailed in Section 2 and are payable by you to Cells4Life in accordance with

the terms of Section 2. The Fees are intended to cover the costs of administration, collection kit,testing, processing and secure storage for the relevant period as detailed therein.

9.2. Any further fees which may be chargeable to you will be notified to you at the time, if applicable.This may include courier service charges which will be charged to you in the event that youwithdraw the Cord Blood in accordance with section 13. We may also charge for our costs incurredin transferring the Cord Blood to another service provider if you wish us to do so in accordancewith section 12.

9.3. If any payment due under this Agreement remains unpaid for a period of more than 14 daysafter the date on which it fell due, Cells4Life shall be entitled to be paid an additional fee of!75 to cover the administration costs incurred in dealing with a late payment. For the avoidanceof doubt the figure of !75 is a genuine attempt by Cells4Life to estimate the costs it wouldincur in those circumstances.

9.4. All of our fees are quoted to include any applicable VAT.

10. Term10.1. Subject to the rights of termination set out in this Agreement the term of this Agreement shall

commence on the date Cells4Life receives this signed Agreement and the Storage Fee and shallterminate after an initial period of twenty five (25) years from the Child’s birth date.

10.2. The Agreement may be continued after expiry of the initial term upon agreement by us and uponreceipt by us of the following:10.2.1. written instructions from the Child that he or she wishes us to continue storing the Cord

Blood; and10.2.2. payment of the appropriate storage fee which shall be notified to you at the time.

11. Your cancellation and termination rights11.1. You may cancel this Agreement upon notifying us in writing as follows:

11.1.1. for any reason, within seven (7) working days of receiving the collection kit providedthat you have not opened the sealed collection kit or used it for any purpose and youreturn the collection kit to us at your cost and in the same condition as when youreceived it; or

11.1.2. in the circumstances set out in Clauses 4.3 or 4.4; or11.1.3. in the circumstances set out in Clause 6.1 or 6.5;11.1.4. at any time by giving thirty (30) days’ notice in writing to us; or11.1.5. in the event that:

(a) a resolution is passed or a winding up order is made for the winding up of Cells4Life;or(b) an order is made for the appointment of an administrator; or(c) a receiver is appointed over any of the assets or undertakings of Cells4Life; or(d) Cells4Life enters into a voluntary arrangement with any of its creditors.

11.2. In the event that you terminate this Agreement under Clauses 11.1.1, 11.1.2 and 11.1.3 we shallrefund the Storage Fees that you have paid to us less any Third Party Costs which have beenincurred.

11.3. In the event that you decide to terminate the Agreement under Clause 11.1.4 we shall refund theStorage Fees that you have paid or that are due to us under the terms of this Agreement on a prorata basis for the balance of any storage term remaining as detailed in Section 2 less any ThirdParty Costs which have been incurred.

11.4. In the event that you decide to terminate the Agreement under clause 11.1.4. or 11.1.5. we shallat your written request (or that of the Child in the event that the Child is 18 or over) uponpayment of all sums due to Cells4Life under this Agreement and at your cost use our reasonableendeavours to procure that the Cord Blood is transferred to an alternative storage provider of yourchoice, provided that transfer to such a storage provider is in compliance with applicablelegislation.


12. !A "#$%#&'%TA '%( )#% %$*+&(, (*'-./%#.*12.1. !"#$#%µ& '( ()*$+,#*µ& -# "($.' /*µ0.1(2# )(2 '( "34#*µ& '( ,(5 "($67#*µ& -25 *"8$&,9&5

µ(5 ,& "&$9"-:,8 "#* &9µ(,-& ('9)('#2 '( ,*'&79,#*µ& '( &)-&1#%µ& -25 *"8$&,9&5 ;2( #"#2#'<="#-&1.;: &)-.5 -#* &16;7#* µ(5 ,*µ"&$21(µ0('#µ6':' ((113 .72 ("#)1&2,-2)3) -:' &>=5: ?&#µ8'9(5,@:-235, "18µµ%$(5 = #"#2(,<="#-& 31185 @*,2)=5 )(-(,-$#@=5, "#16µ#*, )#2':'2)+' -($(7+',('-($,9(5 = 31185 "#12-2)=5 = )#2':'2)=5 ('(-($(7=5, ("&$;9(5 = 31185 ,*'<2)(12,-2)=5)2'8-#"#98,85, <*,&%$&-:' "$+-:' *1+', = (11(;=5 ,-# A.µ#. /& -6-#2&5 "&$2"-+,&25, ?()(-(031#*µ& )3?& "$#,"3?&2( '( ,(5 &2<#"#2=,#*µ& )(2 (' <&' µ"#$#%µ&, ?( µ&-(@6$#*µ& -# <&9;µ(,(5 ,-8' 3118 "$#µ8?&*-2)= &-(2$&9( -85 &"21#;=5 ,(5 *". 2<9(' &*?*'+'. B( ,(5 &"2,-$64#*µ& .,(67&-& "$#"18$+,&2 ;2( -8' *".1#2"8 ("#?=)&*,8 -#* (9µ(-#5.

12.2. !"#$#%µ& '( ()*$+,#*µ& -# "($.' /*µ0.1(2# *". -#*5 .$#*5 -:' $8-$+' 4.2 = 6.512.3. !"#$#%µ& '( ()*$+,#*µ& -# "($.' /*µ0.1(2# ,& "&$9"-:,8 "#* (<*'(-=,&-& '( "18$+,&-& -#

,7&-2). "#,. ;2( -8' ("#?=)&*,8 -#* (9µ(-#5 µ67$2 -$23'-( (30) µ6$&5 µ&-3 "#* (<*'(-&9-& '( -#"18$+,(-& )(2 µ"#$#%µ& '( ("#$$94#*µ& -# <&9;µ( 7:$95 '( ,(5 &'8µ&$+,#*µ&

12.4. !"#$#%µ& #"#-&<="#-& '( ()*$+,#*µ& -# "($.' /*µ0.1(2# &3' <&' -8$&9-& )3"#2( *"#7$6:,=,(5 ,%µ@:'( µ& -# /*µ0.1(2# (*-. )(2 -# ?6µ( <&' 67&2 1*?&9 µ67$2 )(2 -$23'-( (30) µ6$&5 µ&-3

12.5. !& -8' ()%$:,8 -#* /*µ0#1(9#* *". -#*5 .$#*5 -85 $=-$(5 12.2 ?( ,(5 &"2,-$64#*µ& .,( µ(5 67&-&"18$+,&2 "18' -( 6>#<( "#* 9,:5 "18$+,(-& ,& -$9-# µ6$#5

12.6. !& -8' ()%$:,8 -#* "($.' /*µ0#1(9#* ;2( #"#2#'<="#-& 1.;# (µ& &>(9$&,8 ,-25 "&$2"-+,&25 "#* <&'&9'(2 *"#7$6:,8 µ(5 '( ,(5 &'8µ&$+,#*µ&) ?( µ&-(@6$#*µ&, µ& -8' (9-8,= ,(5, -# <&9;µ( ,& 311#"$#µ8?&*-= *". 2<9(' &*?*'+'. !2( -6-#2( µ&-(@#$3 ?( "$(;µ(-#"#28?&9 µ.'# &3' &9'(2 '#µ2)3&"2-$&".µ&'8 )(2 µ(5 67&-& "18$+,&2 -# ("($(9-8-# "#,. ;2( -8' ("#?=)&*,8 -#* <&9;µ(-#5.C3' <&')3'&-& (9-8,8 ;2( µ&-(@#$3 = <&' "18$+'&-& -# ,7&-2). "#,. ("#?=)&*,85 µ6,( ,& -$23'-( (30)µ6$&5, ('(;':$9D&-& .-2 67#*µ& -# <2)(9:µ( '( ("#$$94#*µ& -# (9µ(

12.7. C9'(2 <2)= ,(5 &*?%'8 '( &"20&0(2+,&-& ":5 67#*µ& -8 <2&%?*',= ,(5 )(2 -#* "(2<2#% ,(5 .-(' )1&9,&2-# "(2<9 -( 18 -#* 7$.'2( )(2 µ&-3. C9'(2 &"9,85 <2)= ,(5 &*?%'8 '( &'8µ&$+,&-& -# "(2<9 :5 "$#5 -(<2)(2+µ(-3 -#* .,#' (@#$3 -8' ("#?=)&*,8 -#* <&9;µ(-#5. /*µ@:'&9-& '( )(1%4&-& µ& ("#D8µ9:,8-8 Cells4Life ;2( ("+1&2&5 = 013085 1.;: -85 (<*'(µ9(5 ,(5 '( -8$=,&-& -25 ,7&-2)65 *"#7$&+,&25 ,(5

12.8. /& "&$9"-:,8 ("#-*79(5, -85 &-(2$&9(5, -( <&9;µ(-( ?( µ&-(@&$?#%' ,& 311# 1&2-#*$;2). 7+$#"2,-#"#28µ6'# (". -8' EFG ,%µ@:'( µ& -8 '#µ#?&,9( EF Act 2004

13. , 0%+.1, !.* "2#)'%!.( !.* %#'%!.( !.* .'3%/#.* /&+.*13.1. (,'%4!#$. – B( ,(5 "($67#*µ& -# <&9;µ( ,%µ@:'( µ& -8 ,7&-2)= '#µ#?&,9( &)&9'8 -8 7$#'2)=

"&$9#<# )(2 µ& -8 ;$("-= (9-8,8 ,(5 (= -#* "(2<2#% ,(5 &3' &9'(2 3': -:' 18 &-+') )(2 -#* 2(-$#%"(?#1.;#* ,(5 *". -#' .$# .-2 8 (9-8,8 (@#$3 )(2 -#' 2<23D#'-( )+<2)( -#* <&9;µ(-#5 = &3' 8"($#7= -#* <&9;µ(-#5 ("#-&1&9 <2(-(;= <2)(,-8$9#*. B( "($67#*µ& -# (9µ( µ.'# ,& <2&%?*',8'#,#)#µ&9#* = "$#µ8?&*-= ("#?=)&*,85 &@.,#' 67&-& "18$+,&2 .1( -( ,7&-2)3 6>#<(.

13.2. (,'%4!#$. – H&' ?( ,(5 "($67#*µ& -# (9µ( &3' (*-= 8 "$3>8 ("#-&1&9 "($(09(,8 -#* A.µ#*. I$6"&2'( µ(5 &'8µ&$+,&-& :5 "$#5 -# #'#µ(-&"+'*µ# )(2 -8 <2&%?*',8 -#* "($(1="-8 )(2 -8' 8µ&$#µ8'9("#* -# 7$&23D&,-&. B( 6$?&2 '( "3$&2 -# <&9;µ( # )#%$2&$ µ(5 &3' &9'(2 <*'(-.. /*µ@:'&9-& .-2 &,&95"$6"&2 '( )(1%4&-& .1( -( ,7&-2)3 6>#<( .-(' ?( 130&-& -# <&9;µ( )(2 µ&-3. C3' "$6"&2 -# <&9;µ( '(,-(1&9 6>: (". -# E':µ6'# J(,91&2# ?( "($67#*µ& -# <&9;µ( ,& -$9-# "$.,:"# "#* 67&-& <2#$9,&2 )(2?( &9'(2 <2)= ,(5 &*?%'8 8 1=48 -#* (9µ(-#5

13.3. B( )(-(031#*µ& )3?& "$#,"3?&2( '( ,(5 "($67#*µ& -# <&9;µ( -8' 8µ&$#µ8'9( "#* "$#-2µ3-& (113"$6"&2 '( µ(5 <+,&-& .,# -# <*'(-.' "&$2,,.-&$8 "$#&2<#"#98,8 )(2 ('(;':$9D&-& )(2 ,*µ@:'&9-&.-2 <&' @-(9µ& ;2( )(?*,-&$=,&25 "6$(' -#* &%1#;#* &16;7#* µ(5.

13.4. F# &>#*,2#<#-8µ6'# "$.,:"# "#* 1(µ03'&2 -# (9µ( #µ@312#* 1+$#* ?( "$6"&2 '( *"#;$34&2 -#("#<&2)-2). 6'-*"# "($(1(0=5 ;2( '( &"20&0(2+,&2 .-2 -# (9µ( #µ@312#* 1+$#* 67&2 @-3,&2 ,-8<2&%?*',8 -8' ,*;)&)$2µ6'8 ,& )(1= )(-3,-(,8. C,&95 ?( &9,-& ("#)1&2,-2)3 *"&%?*'#5 ;2( -# (9µ(#µ@312#* 1+$#* (µ6,:5 µ.125 "($(<#?&9 )(2 ("#<67&,-& .-2 &µ&95 <&' &9µ(,-& "16#' *"&%?*'#2.

13.5 C"2-$&".µ&'8 7$=,813.5.1 C)-.5 (' #2 .$#2 "#* "$#016"#'-(2 ,-8' "($3;$(@# 13.5.2. -8$#%'-(2, -# (9µ( -#*

#µ@312#* 1+$#* "#* ("#?8)&%&-(2 *". -#*5 .$#*5 -#* "($.' /*µ0#1(9#*, ?(("#<&,µ&%&-(2 ;2( (*-.1#;8 7$=,8, <81(<= ;2( 7$=,8 µ.'# ("&*?&9(5 ;2( -# I(2<9

13.5.2 G' -# (9µ( #µ@312#* 1+$#* B( ("#?8)&*-= ;2( (*-.1#;8 )(2 (11#;&'= 7$=,8, <81(<= ;2(7$=,8 ,& 311# "$.,:"# )(2 .72 -# "(2<9, 6'( ().µ8 <&9;µ( (9µ(-#5 -85 µ8-6$(5, "&$3' (*-."#* ("(2-&9-& 03,&2 -85 "($(;$3@#* 6.3, "$6"&2 '( "($(<#?&9 180 8µ6$&5 µ&-3 -8 ;6''8,8.G*-. -# <&9;µ( (9µ(-#5 ?( "$6"&2 '( *"#,-&9 ('(1%,&25 ,%µ@:'( µ& -8' "($3;$(@# 6.3. /&"&$9"-:,8 "#* (*-. -# <&9;µ( (9µ(-#5 <&' "$6"&2 '( ,*116;#'-(2, = <&' &9'(2 02+,2µ8 ;2(-25 ('(1%,&25, -# (9µ( #µ@312#* 1+$#* <&' µ"#$&9 '( 7$8,2µ#"#28?&9 ;2( (11#;&'= 7$=,8)(2 8 Cells4Life <&' &*?%'&-(2 ;2( -*7.' ("+1&2&5 "#* "$#)%"-#*'.

13.5.3 K". -8' &"2@%1(>8 -85 "($(;$3@#* 3 "2# "3': 8 Cells4Life µ"#$&9 '( <+,&2 &"2"16#' /&-/*11#;=5 G9µ(-#5 -#* Lµ@312#* M+$#* ;2( -8 ,*11#;= -#* "&$(2-6$: <&9;µ( (9µ(-#5 -85µ8-6$(5.

14. !. %0.++,!. $%# , 0+.(!%(#% 0+.(&0#$&4 "2".'24&414.1. E Cells4Life ?( )(-(031&2 )3?& "$#,"3?&2( '( <2(-8$8?#%' (".$$8-( -( "$#,:"2)3 ,-#27&9( "#*

(@#$#%' &,35 )(2 -( "(2<23 ,(5. N1( -( <&9;µ(-( "$#5 <#)2µ= ?( "$6"&2 '( &"2,8µ(9'#'-(2 µ&µ#'(<2). ($2?µ. ('(@#$35 )(2 ;$(µµ#)+<2)( B( ,(5 "($67#*µ& -( "$#,:"2)3 <&<#µ6'( ,(5 µ.'# ,&"&$9"-:,8 "#* -( D8-3-& &,&95 = # 2(-$.5 "(?#1.;#5 ,(5 ;2( '( -( 031&2 ,-# @3)&1# -#* 2(-$2)#%2,-#$2)#% ,(5. F( &' 1.;: <&<#µ6'( <&' ?( <#?#%' ,& -$9-# µ6$#5 &)-.5 (' µ(5 -# "$#O"#?6,&2 #,7&-2).5 A.µ#5


12. Our cancellation and termination rights12.1. We may terminate this Agreement and stop providing the Services to you at any time in the event

that we are unable to continue to perform the Services for any reason beyond our reasonablecontrol including (but not limited to) an Act of God, fire, flood or other natural disaster, war, riot,insurrection or other civil commotion, strike lock-out or other industrial action, embargoes,shortage of labour, unavailability of raw materials or a change in the law. In such circumstances,we will endeavour to notify you and, if you request us to do so and if we are able to do so, we willtransfer the Cord Blood to your alternative nominated storage provider at your risk and cost. Weshall refund the balance of any Storage Fee you have paid on a pro rata basis for the balance of anystorage term remaining as detailed in Section 2.

12.2. We may terminate this Agreement in the circumstances set out in Clauses 4.1 or 6.5.12.3. We may terminate this Agreement if you fail to make any payment in respect of the Storage Fees

within thirty (30) days after such payment falls due. If this Agreement is terminated in accordance withthis clause 12.3 ownership of the Cord Blood will pass to us and we may then dispose of or otherwisedeal with the Cord Blood as we see fit including, but not limited to, allogeneic use (i.e.for use on aperson other than the Child) without any further reference to you. In those circumstances clause 13shall not apply.

12.4. We may (without limiting any other remedy available) at any time terminate this Agreement by givingnotice to you if you do not comply with any of your obligations under this Agreement and (if possible)fail to resolve the issue within thirty (30) days after being required to do so.

12.5. Upon termination of this Agreement under Clause 12.2 we shall refund the Storage Fees that youhave paid to us less any Third Party Costs which have been incurred.

12.6. Upon the termination of this Agreement for any reason (except where indicated that there is norequirement of further reference to you) we will, at your request, transfer the Cord Blood to anotherStorage Provider at your risk and cost. Such transfer to another Storage Provider will only beeffected where we are legally permitted to do so and once any sums due to Cells4Life from you inrespect of the Storage Fees have been paid. If you do not request the Cord Blood to be transferred toanother storage provider within thirty (30) days of the termination of this Agreement, or you fail tomake all due payments within thirty (30) days of termination of this Agreement, you acknowledgeand agree that we may dispose of the Cord Blood at our sole discretion.

12.7. It is your responsibility to ensure that we have a current contact address for you and also for theChild once the Child has reached the age of 18. It is also your responsibility to advise the Child of anyrights it may have in relation to the Cord Blood. You agree to indemnify Cells4Life against any loss ordamage it may suffer as a result of failure to do this.

12.8. In the event of corporate failure the samples will be moved to an HTA licensed storage premises inaccordance with the Human Tissue (Quality and Safety for Human Application) Regulations 2007.

13. Release of cord bloodThis clause 13 shall apply except where this Agreement has been terminated in accordance with clause12.3, in which case it will cease to be of any effect.

13.1. IMPORTANT – We will only release the Cord Blood in accordance with legislation prevailing at the time,and on the written request of you (or your Child if over eighteen (18)) and the treating medicalpractitioner provided that the request gives the Child’s unique reference number, or if release isrequired by any Court Order. We will only release the Cord Blood to a designated hospital address, oran alternative storage provider, and provided all Fees due having been paid.

13.2. IMPORTANT – We will not release the Cord Blood where to do so would contravene any law. Anynotice, from you or a physician, must state the name of the individual and the address to which theCord Blood should be delivered and the date upon which it is required. We shall arrange for ourcourier to deliver the Cord Blood to that address and on that date if reasonably possible. You agreethat the costs of delivery are at your sole expense and we may invoice you for any such costsincurred which you agree to pay by return upon receipt. If you wish the Cord Blood to be deliveredto an address outside of the UK mainland, we will release the Cord Blood to your authorised personat our premises and you will then be solely responsible for delivering the Cord Blood to yourchosen address.

13.3. We shall use all reasonable endeavours to deliver the Cord Blood on any requested date but youmust give us as much notice as possible and you acknowledge and agree that we will not be responsiblefor any delays in delivery beyond our reasonable control.

13.4. The authorised person who receives the Cord Blood will be required to sign an acknowledgement ofreceipt form to confirm that the Cord Blood has been received at the named address in good order.You will be solely responsible for the Cord Blood as soon as it is delivered and you accept that we willno longer be responsible.

13.5. Permitted use13.5.1 Unless the conditions set out in paragraph 13.5.2. are complied with, Cord Blood stored under

the terms of this Agreement shall be released for autologous use only, i.e. for use directly forthe child.


!"#$%&'( µ)*+%&,:!"#$%&'( ____________________________________________ («) *+,-%&»)

)µ.%#µ+/0& ______________________________________ 20 _______________

1/#µ&,."2/3µ# ________________________________________________________

!"#$%&'( -)./µ01&:(4. ".%0",54+ "#3 + µ+,-%& .0/&6 78,5 ,5/ 18 9%#/2/)

!"#$%&'( ____________________________________________ («) *+,-%&»)

)µ.%#µ+/0& ______________________________________ 20 _______________

1/#µ&,."2/3µ# ________________________________________________________

14.2. ) Cells4Life .0/&6 7&,&95%+µ-/+ 4,# µ+,%2# ,+: /#µ#;.40&: Data Protection Act 1998 7&6 ;&.".<.%$&4,.0 =>& ,& "%#45"678 ?.?#µ-/& 4@µ'5/& µ. ,6: 3"#9%.24.6: "#3 ;-,.6 &3,( + /#µ#;.40&.!"#$%8'#/,&: ,# "&%=/ A3µB=>&6#, ?0/.,. ,+/ 43$7&,8;.4+ 4&: /& ?6&,+%(4#3µ. 7&6 /&.".<.%$&4,#@µ. ,& "%#45"678 ?.?#µ-/& 4&: 7&6 ,#3 "&6?6#@ 4&: $6& /& .7,.>-4#3µ. ,6:3"#9%.24.6: µ&: 4@µ'5/& µ. ,# C=µ# 7&6 &/&$/5%0D.,. =,6 µ"#%#@µ. /& &"#7&>@E#3µ. ,& ./ >=$5?.?#µ-/& 4,#/ $6&,%= 4&: ( ,#3 "&6?6#@ 4&: .8/ µ&: ,# "%#F"#;-,.6 # 49.,67=: C=µ#:. G>>62:, ?./;& &"#7&>@E#3µ. ,& ?.?#µ-/& 4. 7&/-/& ,%0,# µ-%#: 95%0: ,+/ 8?.6& 4&:. H>.: #6 &6,(4.6: "%-".6/& µ&: 4,&>#@/ $%&",2:

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Signature of MotherSignature ____________________________________________________________

Signed this _____________ day of _____________________ 20 ________________

Name printed ____________________________________________________________

Signature of Legal Guardian(if Mother under 18)

Signature ____________________________________________________________

Signed this _____________ day of _____________________ 20 ________________

Name printed ____________________________________________________________

13.5.2. If Cord Blood is to be stored for autologous and allogeneic use, i.e. for use on a personother than the child, a further maternal blood sample, in addition to that required underparagraph 6.3, must be provided 180 days after the Birth. This further maternal bloodsample will be subject to testing in accordance with paragraph 6.3. Should the furthermaternal blood sample not be collected, or is not viable for testing, the Cord Blood maynot be used for allogeneic use and Cells4Life shall not be liable for any resulting losses.

13.5.3 Subject to pargraph 3, above, Cells4Life shall supply an additional collection kit forcollection of the further maternal blood sample.

14. Confidentiality and data protection14.1. Cells4Life will use all reasonable endeavours to keep confidential all information relating to you and

your Child. All samples to be tested will be labelled with unique reference numbers and bar coded.Personal information will only be held on our secure database and/or database backup. Informationheld by Cells4Life will only be released if required by your or your Child’s medical practitioner fortheir internal confidential records or otherwise as requested by you. None of the information held onour database will be disclosed or released to third parties other than as required by law.

14.2. Cells4Life is registered under the Data Protection Act 1998 and will process all personal data inaccordance with its obligations under that Act. By signing this Agreement, you consent to ourholding and processing your and your Child’s personal data (including sensitive personal data) forthe purposes of performing our obligations under this Agreement and you also acknowledge andagree that we may disclose any such personal data to your or your Child’s medical practitioner onrequest or as otherwise required by law. Otherwise we will not disclose personal data to any otherparty without your consent. All requests must be made in writing to Cells4Life.

15. Miscellaneous15.1. You understand that this Agreement is binding upon you and your respective successors and assigns.15.2. No variations to this Agreement shall be made unless agreed in writing by us.15.3. English law shall apply to this Agreement and the English Courts shall have the non-exclusive

jurisdiction to resolve any disputes arising out of this Agreement.15.4. If any provision of this Agreement is decided by any Court or other competent authority to be

wholly or partially invalid or unenforceable, the other provisions of this Agreement and theremainder of the provision in question shall not be affected and shall remain valid and enforceable.

15.5. This Agreement is solely for your benefit and, cannot be transferred to any other party. No expressterm of this Agreement or any term implied under it is enforceable pursuant to the Contracts(Rights of Third Parties) Act 1999 by any person who is not a party to it.

15.6. If you change your address or any other details, you must promptly notify us in writing. You areresponsible for ensuring that we have an up to date address for you and the Child once the Childreaches the age of 18 so that we may contact you and/or the Child if necessary.

15.7. This agreement embodies the entire agreement and understanding between us and supersedes allprior oral or written agreements, understandings or arrangements. Neither party shall be entitled torely on any agreement, understanding or arrangement not expressly set out in this agreement savefor any representation made fraudulently.

By signing this agreement, you agree that you understand, acceptand agree with the above terms:


4! "#$!%

!"#$%&'µ()*% "+,-.µ/ µ% "0)*.*01/ 12-*(, &-,µ(*01/ %"0*(3/, / *-("%401' 5µ6()µ(.728 %"09:µ%;*% 8( "+,-<)%*% µ% %"0*(3/ / *-("%401' 5µ6()µ( "(-(1(+#=µ% 8()03#:-%:*%;*% '*0 *# %"<8:µ# *,> µ,*5-(> :"(-&%; .> (8(?#-2 "+,-.µ/>.

"& '()µ*+,-. &/,+*0.:@(-(1(+#=µ% #0 %"0*(35> 8( %;8(0 "+,-.*5%> )*# '8#µ( Cells4Life Cyprus Ltd 1(0 8()*(+#=8 )*,8 %A/> $0%=9:8),:

36 7:(3'-#:B-µ/$%0(, C2-8(1(7530, D="-#>

Section 4We accept payment by credit card, debit card, cheque or bank transfer. If paying bycheque or bank transfer please ensure the Mother’s surname is provided as the paymentreference.

By chequePlease make cheques payable to C4L Cyprus Ltd and send to:

C4L Cyprus Ltd3b Evagorou StreetOrmidheiaLarnaca7530, Cyprus

"& +(*/&1,-2 3µ4*5µ*:E8#µ( *-2"%4(>: FG!@7H! DI@GBI J.7.J.7.E8#µ( :"#1(*()*/µ(*#>: K#82$( 30( J0%98%;> 7"0&%0-/)%0> - C2-8(1(D<$01(> *-2"%4(>: 0582

!-09µ'> +#3. (7:-<): 0582-01-024453!-09µ'> +#3. (L*%-+;8%>): 0582-40-01-062397

By bank transferBank Name: BANK OF CYPRUS PCLBranch Name: International Business Unit - LarnacaBranch Code: 0582Euro account No.: 0582-01-024453GBP account No.: 0582-40-01-062397


!" #"$%#&'() #*+ ,#*-,(%("&" ., #/)$0("&" µ! µ"#$%&!' ()"µ%*$+,' -./!$', (,1#,$,2,/*3µ" ., (+µ#/)$0("&" &* #,$,24&' 5.&+#*:

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6.*µ, &$4#"7,1 _____________________________ BANK OF CYPRUS PCL

89"3:+.() &$4#"7,1 _____________________________ INTERNATIONAL BUSINESS UNIT

_____________________________ 45, ARCH. MAKARIOS AVENUE

_____________________________ P.O. Box 40093

_____________________________ 6300 LARNACA

_____________________________ CYPRUS

_____________________________

;$9:µ<1 /*=,$9,(µ*3 _____________________________ 0582-01-024453

6.*µ, /*=,$9,(µ*3 _____________________________ C4L (CYPRUS) LIMITED

8*1$(!&% 6<");µ4'

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?*(< µ).9,%,1 @<()1 A _____________________________________

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G)/. ?"/4&) ______________________________________

Page 21

?HI?IJ K; I?J!GHILIGI GF ?;HFK IKGM?F !GC CELLS4LIFE


!" #"$%#&'() #*+ ,-"&" "#./,0". &* 1&2(.* !-,3.* 4#*526"+()7, #8$868/*9µ" (+µ#/)$:(&"#/2$'7 &* #8$86;&' ,<&+#*. 1;< 58 3)µ.*+$=2("&" #;=.8 "<&*/2 )/"6&$*<.6;, #8$868/*9µ"<8 (.=*+$"+&"%&" >&. &* "#:<+µ* &)7 µ)&,$87 #8$,-"&8. '7 8<8?*$; =.8 &)< #/)$'µ2.

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@<*µ8 &$;#"A87 _____________________________ BANK OF CYPRUS PCL

B."95+<() &$;#"A87 _____________________________ INTERNATIONAL BUSINESS UNIT


_____________________________ P.O. Box 40093

_____________________________ 6300 LARNACA

_____________________________ CYPRUS

_____________________________

4$.5µ>7 /*=8$.8(µ*9 _____________________________ 0582-01-024453

@<*µ8 /*=8$.8(µ*9 _____________________________ C4L (CYPRUS) LIMITED

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4$.5µ>7 #/)$'µ27 ("#%()µ) -$2()) ______________________________________

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H)/,?'<* "#.6*.<'<%87 µ" #"/;&) ______________________________________

Page 22

HF C4IFJ 1JHGCF CI1C1K J4 1CK!HI4L1K !HE CELLS4LIFE


In the event that you elect for the Spread payment option, please fully complete theform below. If you are creating a standing order electronically please ensure the Mother’ssurname is provided as payment reference.

To The Bank Manager:

Details Account to be debited Beneficiary details

Bank name _____________________________ BANK OF CYPRUS PCL

Bank address _____________________________ INTERNATIONAL BUSINESS UNIT


_____________________________ P.O. Box 40093

_____________________________ 6300 LARNACA

_____________________________ CYPRUS

_____________________________

Account number _____________________________ 0582-01-024453

Account name _____________________________ C4L (CYPRUS) LIMITED

Payment details

Payment reference (official use) ______________________________________

Amount of each monthly payment ! _____________________________________

Amount of each payment in words ______________________________________

Date of first payment ______________________________________

Frequency of payment Monthly

Number of payments 5 or 11

Customer name ______________________________________

Customer signature ______________________________________

Customer contact number ______________________________________

Page 23

THIS FORM IS TO BE RETURNED TO CELLS4LIFE


In the event that you elect for the Annual Storage Plan, please fully complete the form below.If you are creating a standing order electronically please ensure the Mother’s surname isprovided as payment reference.

To The Bank Manager:

Details Account to be debited Beneficiary details

Bank name _____________________________ BANK OF CYPRUS PCL

Bank address _____________________________ INTERNATIONAL BUSINESS UNIT


_____________________________ P.O. Box 40093

_____________________________ 6300 LARNACA

_____________________________ CYPRUS

_____________________________

Account number _____________________________ 0582-01-024453

Account name _____________________________ C4L (CYPRUS) LIMITED

Payment details

Payment reference (official use) ______________________________________

Amount of each annual payment ! _____________________________________

Amount of each payment in words ______________________________________

Date of first payment ______________________________________

Frequency of payment Yearly

Number of payments ______________________________________

Customer name ______________________________________

Customer signature ______________________________________

Customer contact number ______________________________________

Page 24

THIS FORM IS TO BE RETURNED TO CELLS4LIFE


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Page 2


Please ensure you EITHER sign or initial EVERY PAGE to confirm your consentto a section OR write NOT CONSENTED in the section.

INTRODUCTION:

There are two copies of this document provided in each Welcome Pack. One copy is to be kept foryour records and the other should be returned to Cells4Life with the completed Terms and Conditions.The purpose of this document is to provide you with information regarding the Cells4Life services andprocesses and the law in the UK under which Cells4Life is licensed. This document needs to be read inconjunction but not limited to the Welcome Pack folder and the Terms and Conditions as provided byCells4Life.

You may also wish to refer to other sources of information such as the Cells4Life website, the HumanTissue (Quality and Safety for Human Application) Regulations 2007 website for legislative information,the Royal College of Obstetricians and Gynaecologists (RCOG).

This document aims to:

1. Describe the regulatory framework and how it affects you and any decisions you makeregarding procurement of your cord blood;

2. Describe the processes involved, who is responsible for each step and what the choicesare; it also details what will happen if these processes are not followed and whatimpact this might have on the sample and you.;

3. Describe what tests will be done and when, also what the results might mean;

4. Describe when and how consent can be withdrawn;

5. Describe the steps that will be taken and what communications you will receive from Cells4Life;

6. Describe Cells4Life’s current and ongoing role and responsibilities;

7. Describe your current and on-going role;

8. Record your consent to the processes and practices.

This Consent Booklet is how Cells4Life will record your wishes in respect of the Cells4Life service. Youneed to complete this and return it to us. By law we have to verify that you are capable of providingconsent and further that you are making an informed decision. This is done by means of a short phonecall to review and verify the information you have provided.

Please contact Cells4Life to discuss any aspect on which you may be unclear or for further information.It is strongly recommended that all parents of the Child or Children read this information and ensurethey are aware of how the process works. This is important as the Mother may not be able to or maynot wish to communicate instructions as to how, for instance, the courier should be notified.

IMPORTANT INFORMATION ABOUT THE LAW

The legislation relevant to the Cells4Life service is the UK Human Tissue Act 2004 and associatedRegulations, such as the Human Tissue (Quality and Safety for Human Application) Regulations 2007.

Page 3


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The regulatory body for this is the Human Tissue Authority (HTA). Cells4Life is licensed by the HTAwith license number 11083 in the UK and license number 5.4.03.2.28 in Cyprus. Further informationcan be found at www.hta.gov.uk. Some aspects of this law affect you even if you are not giving birthin the UK and even if you are not living in the UK. This is because the legislation governs Cells4Life.

Consent and withdrawing it

The law requires many items to be in place. Specifically for customers of Cells4Life we have to assureourselves that consent is both informed and freely given. This means we have to advise you of theservice, likely outcomes of each part of the service and how it progresses. Further you must have hadthe opportunity if you want to discuss this with other people and/or organisations and read othermaterial relating to this.

There is a Consent Form which is at the back of this booklet. Please read the whole of this bookletand then complete this Consent Form. Cells4Life will then contact you to verify that this is valid.

In addition to ensuring you know about the service we need to tell you how to either refuse to consentor withdraw your consent. Simply, if you do not want to proceed with the process of collection ortesting or storage at any point in time you need to contact us and let us know. We will usually ask forthis to be confirmed in writing if this is given orally.

If you chose not to go ahead with the service after obtaining a Collection Kit and before the blood iscollected you will usually only have to pay the deposit.

If you choose to withdraw consent for the storage after the blood has been processed, you will usuallyhave to pay all monies except for some of the remaining Storage Fee or Annual Storage Fee.

In either case you have to be aware that the blood is not available for use at any point in time for anyreason. We will ask you to complete a form which documents this.

You may withdraw your consent at any time for any reason. The identity and right to withdraw mustbe verified before withdrawal will be recognised. This will be kept on file. We need a signature tomatch to the documentation we already have to confirm this. Withdrawing consent can be for all orpart of the service. In the event that you withdraw your consent for any part of the service there maybe implications for you and for the sample. Some examples are detailed below, however we wouldencourage you to contact us and discuss to ensure understanding. You may also want to discuss thiswith your family and other health care professionals.

The other critical item which can immediately affect the service is who may legally procurecord blood samples.

Cells4Life has to be able to provide evidence that the person who procured the cord blood isappropriately trained and licensed to do so. This means that the person who actually makes thesample available using the Collection Kit has to be either licensed by the HTA or working under a ThirdParty Agreement (TPA) with Cells4Life.

We advise you to talk to your doctor to confirm your doctor is legally compliant, (i.e. that the personwho you wish to procure your Child's cord blood is appropriately trained and licensed) then we willissue a Collection Kit to you.


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Page 6


IMPORTANT:

If you tell us that a specific person or organisation is procuring your Child’s cord blood but theprocedure is then carried out by someone else who we are unable to verify is appropriately trainedand licensed we have to report this to the HTA. The HTA may require that the sample be disposed ofor may require that it is exempt from human application. Further, the persons involved in theprocurement may be liable for legal action by the HTA. This could be you as the Parents. Any personsinvolved in the unauthorised procurement of a sample commits an offence and is liable toprosecution. If the cord blood sample is to be procured by anyone other than the person you notifiedus of, you must ensure they are authorised to do so.

THE CELLS4LIFE PROCESS

Before the Birth

As Parents you should read the literature provided by Cells4Life and any other organisations you obtaininformation from. It is important that you obtain enough information to be happy to make a decisionto proceed with private cord blood storage.

Once we have confirmed that the planned procurement will be legally compliant, consent has beenobtained, the Terms and Conditions document agreed to and deposit paid, a phone call may be madeto you to verify the consent. The kit will be dispatched to the Parents by Cyprus Mail, Special Deliveryor other nominated courier service. This is a two day delivery service. We are able to arrange a sameday delivery service but this is an additional cost.

The Kit will be made available at time of birth to the Procurer by the Parents and the Parents willallow only the nominated confirmed person or organisation to procure the cord blood. If this is notpossible then you should not permit procurement to occur unless the alternative has been confirmedas being licensed and trained for cord blood procurement as per the Human Tissue Act. If illegalprocurement occurs, you need to be aware that legal action may be taken by the HTA against allparties involved in this.

The Procurement process is detailed with pictures in the Cord Blood Collection Protocol inside the box– briefly it is described here.

What happens at the birth?

! Management of the birth is not to be altered.

! Kit to be handed to the Procurer at the place of birth

! Procurement is advised to occur after the third stage of labour with the placenta exutero, in accordance with current published guidance from RCOG. In the eventmedical risk assessment by the attending healthcare professional at the time of birthindicates procurement should occur in utero, this will be documented. If you do notwant in utero procurement to occur, you must specify this to the Procurer.

! Procurement tools provided to be laid out. Some hospitals want this to be done in aseparate room from the birth)

! Birth process completed and placenta made available to the Procurer

Page 7


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! Placenta is examined, needle insertion site disinfected

! Needle inserted into vein, blood flows into bag. Manipulation of placenta and vein useful toimprove blood flow.

! Line clamped and tied, needle removed from bag and disposed of

! Bag placed in protective packaging

! Maternal sample obtained, placed in protective packaging. If this cannot be obtained (e.g.due to low vein pressure the Maternal Sample Kit should be retained, a sample obtainedwithin 7 days of the birth and returned to Cells4Life. Please ensure appropriate notes aremade on the documentation to advise if this course of action is needed. Please ensure thisis sent by recorded delivery only.

! Packaging sealed and placed in box

! Procurer completes paperwork and places in box

! Box handed to Parents

! Parents to sign box and call the courier number to arrange collection. Our couriers willadvise when the nearest van will arrive. Collection may take several hours and at busyperiods this may take longer. It is expected that all blood samples will be collected fromthe Parents within 12 hours. It is the responsibility of the Parent NOT the Procurer toarrange the courier collection by calling the number.

At the lab

The courier will return the blood sample(s) to the laboratory staff. This will then be processed. TheCells4Life process involves minimal manipulation, which has been shown to be better for thesample(s). This process retains all the stem cell types indentified in cord blood, as well as all thegrowth factors and hormones and the “Cord Blood Factor” known to be so beneficial in a clinicalsetting. Please see the Cells4Life Library on the web site for further information and the latestresearch papers on this.

In the lab all the paperwork is checked for compliance with the legislation. The sample(s) isprocessed in our state of the art soft wall clean room. The sample(s) is assessed for volume and has a20% DiMethylSulfOxide (DMSO) solution added to it in 1:4 ratio, the sample(s) comprising ofanticoagulant and blood. This is the cryoprotectant - it coats all the cells and helps prevents burstingof the cells when freezing takes place. No method of freezing is 100% perfect and some cells willalways be damaged however this method has been used since cord blood has been frozen and is acommon factor regardless of the manipulation technique employed.

There is a lot of hype surrounding the presence of red blood cells in frozen samples, with spuriousclaims that these are more likely to burst and cause kidney failure. Please see the Cells4Life WholeCord Blood policy in this pack and on our web site for scientific references which demonstrate thesafety and efficacy of whole cord blood storage.


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!" µF,*-.D #$%&µ' 1,266$,'- 1$ 566" $*&'1,H*- &-' $E2,'1F. PJµ4)9' µ$ ,"9 1($,-.D 9Dµ", )3/*"6F/,-.D µ2,*" /*2/$- 9' $E$,'1,$% .'- F µF,2*' L1,$ 9' µF9 8/5*($- '95&.F 9' 8/"1,$% /$*-,,23-',*-.23 $E$,51$-3/ /*5E$-3 ," 9$"&299F,". <- 9D1"- /"8 $E$,5+"8µ$ 2("89 '9'&9)*-1,$% )3$/-.%9#89$3 1$ µ$,'µ"1($J1$-3:

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! PJ4-6F

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Page 10


The sample(s) is sub-divided into a number of small vials (the exact number depends on the volume ofblood collected). There will be at least TWO 2ml vials and then between ONE and THREE 5ml vials.

Testing

We then need samples for testing :

! viability analysis

! post-freeze analysis.

! bacterial analysis

The analysis samples are a few drops of blood each. The remainder of the sample – the majority ofthe blood – is stored in a cryogenic bag.

All the vials and the bag have a unique reference on them – the ones for freezing are then placed inspecial boxes and subsequently frozen in a slow and controlled manner from room temperature tominus 80oC. This takes up to 24 hours depending on sample size. After this time the sample is placedin quarantine tanks until the testing is completed.

The bacterial analysis sample is placed in an incubator where the nutrients provided and the warmtemperature encourages any bacteria to grow. After 48 hours these are smeared onto special plateswhich allow any contaminants to grow and be identified.

The viability of the sample is assessed – that is to say that the number of living cells is counted. Thisis done by counting all the cells, then staining the dead cells and counting them and working out thepercentage of the two numbers. In Cells4Life’s opinion, samples with a viability of lower than 70%before freezing are unlikely to be of clinical use.

The Maternal sample is sent to a third party lab for testing. Maternal samples are tested as requiredby law. The diseases which are tested for have been identified as being potentially hazardous in atransfusion / transplant setting. At present these are:

! HIV I and II

! HTLV (Human T cell Lymphotrophic Virus)

! Syphilis

! Hepatitis B

! Hepatitis CYou need to be aware that not all these are tested for in pregnancy, and therefore this may provideyou with previously unknown information regarding your health status. We ask that we are able toprovide this information to your doctor. If you do not provide us with the consent to do this, we willwrite to you advising of any positive results, and advise you to seek medical advice. You are thenresponsible for doing this.

We will need your consent to disclose results of testing to any medical practitioner who is consideringusing the sample in the future.

Page 11


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What happens if there is a problem?

In the event that there are any problems with the sample at any point you will be contacted. IfCells4Life has evidence or reason to recommend the disposal of the sample we will tell you. If it ispossible for the sample to remain in storage BUT you need to be advised of possible limitations in theuse of this, we will tell you. It is then your decision whether to continue storing the sample. Youmust realise that if you decide the sample will not be of use in the future, you will be charged for theservice provided to date and only be able to reclaim the amount of money paid as a storage fee.

The only time Cells4Life will not process the sample is if the blood is not able to be processed, forinstance the sample was not mixed with the anti-coagulant in the collection bag, or the sample hasclotted in the collection tubing. This is because even small samples might be used with amplificationtechnology to provide a therapeutically useful sample. This technique is currently in clinicalevaluation. Amplification technology is where the stem cells are encouraged to create just more stemcells. More information can be found in the Welcome Pack folder and on our web site.Cells4Life will only provide you with confirmation of all the sample test results once full payment isreceipted. We will contact you once the sample has been received and processed in the lab toconfirm the blood volume and viability only, all other tests will not have been completed.If there is contamination then you will be asked to confirm that you realise it may affect thepossibility of the sample being used. Realistically the only time anyone will have hard evidence anddata for this decision will be when the person who is ill is present. Only then can all the factors of thediseases, complications, other sample availability and possible medication implications be known,however the decision as to whether to store this or not rests with you.

Paying and reporting the results

Once all the details of the sample are confirmed and payment is receipted you will obtain acertificate detailing the results.

Cells4Life will then move the sample from the quarantine tanks to the permanent storage tanks,unless there is evidence of contamination or non-compliance when it will be stored in a designatedNon-Compliance tank.

All the tanks used by Cells4Life are the same type – that is to say these are vapour phase jacketedliquid nitrogen tanks. Storage in the vapour phase of liquid nitrogen has been shown to be the safest.The jacketed tanks have consistent temperature from top to bottom, which means the temperature ofthe samples is consistent.

These tanks have a series of other built in safety features:

! the reservoir in the tanks is sufficient to ensure temperature is maintained even inthe event of a power failure

! The supply of liquid nitrogen can be done independently of a power source

! The rate of liquid nitrogen usage is low because of the jacketed approach

! All tanks are alarmed


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Page 14


You need to be aware Cells4Life will process and store any sample size because we believeamplification technology will be approved in the near future and thus all samples have the potentialfor clinical use. Samples with a low volume and/or cell viability may not be useful for, say, leukaemiain the near future. You will therefore need to look at the sample results and make a choice based onyour personal beliefs and requirements for the sample as to whether you want to store it or not.

Cells4Life strongly believes that all samples will be useful in some setting – the pioneers of cord bloodusage have documented that even if the uses do not increase much, the chances of people using stemcells are 1 in 200 in a lifetime. We therefore do not recommend that for the future use aspectanyone destroys a sample.

If you decide not to go ahead with the service, or cannot for any reason have the cord bloodcollected, then there may be financial implications. You will lose the deposit and any additionalemergency courier fees paid. The only time this does not happen is if you have purchased the servicewithin 7 days of this occurring.

If you have employed a third party to procure the cord blood for you then there may be fees due onthis service. You need to refer to the terms and conditions of service of the party providing theservice.

If you cannot or do not want to provide a Maternal sample then the cord blood testing cannot be fullycompleted. Maternal samples need to be provided at or within 7 days of the birth by law. Failure toprovide a suitable Maternal sample will mean the cord blood sample will be stored as non-compliantand may mean further testing has to be carried out before the sample can be used. This might have acost and time implication. At present this testing would have to be by NAT PCR (Nucleic AcidAmplification Testing by Polymerase Chain Reaction).

If you decide you do not want the sample to be processed after it is collected by the courier you needto contact the lab immediately, but please bear in mind this process might be underway already. Youwill lose the deposit and courier fees.

If you decide that you do not want the sample to be stored on the basis of the initial test results, thenyou need to put this in writing. Please bear in mind that the maternal and bacterial analysis willalready be underway but where possible this will be stopped. You will be charged for the service lessstorage fees.

If you decide that the sample should not be stored at any point after processing and testing becauseyou have been advised of a possible limitation of use due to contamination you will be refunded allfees except the deposit.

If you decide that the sample should not be stored at any point for any reason, except contamination,after the sample is processed and testing complete you must tell us in writing and you will be asked toconfirm that you have understood the implications of amplification technology and how this mightbenefit you or your Child in the future. You will be charged all fees except the remaining element ofthe storage fees.

If you decide not to allow us to advise a medical person of any positive results, you will still be told ofthe results by Cells4Life. We will recommend that you tell your doctor of these results as it mayimpact your health and the health of others. Cells4Life does not operate a counselling service but wecan advise you of where help can be found.

Page 15


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1*&2$(34 ___________________________________________________________

5µ/$&µ"6.( ___________________________________________________________


If you do not provide us with consent to disclose the results of the testing to any medical practitionerwho may need to use the sample in the future, you need to consider that this may prevent the samplefrom being used. It may delay the use of the sample and therefore the treatment whilst otheralternatives are found and investigated.

Should any part of the service not be available due to your decision to withdraw consent we willadvise you. Your consent to the various parts of the service is recorded by your completion of theConsent Form at the end of this booklet. This is separate from the Terms and Conditions.Please be aware that due to the nature of birth we ask that the expected birth partner also reads andconsents to certain sections. This is especially important regarding the procurement and making theKit available to persons. This is because of the legal implications of unlicensed procurement.

Please discuss this service with your family, friends and medical practitioners. You will need toconfirm certain aspects for your self. Cells4Life will provide you with as much assistance as we can inthis issue. Please refer to the covering letter sent with the Welcome Pack where we will havedetailed any information we are already aware of which can assist you in this.

Records and Disposal

Cells4Life maintains a register of hard copy and electronic copy of all pertinent information asproscribed by The Regulations. This will include the consent, test results and information relating tothe processing of the sample.

Any personal or medical information about you collected in connection with the service will betreated as confidential and will be kept in accordance with relevant legislation and disclosed only incircumstances permitted by law. Testing will be undertaken in accordance with the current legislationto safeguard you.

In the event the sample has to be destroyed, this will be done by autoclaving and incineration via anappropriately licensed third party in accordance with the medical waste legislation in force at thetime.

The sample is only identified by the number on it, and linkage of the names to the numbers onlyoccurs on the contract and on the electronic register. The confidentiality of these is maintained byboth physical and technological security measures.

The paper records are required to be maintained for specified periods and Cells4Life will maintainthese records accordingly.

Questions

You are entitled and encouraged to ask us questions about any part of the service which you do notfully understand. It is very important that you do not give your consent until all your questions havebeen satisfactorily answered. We will contact you upon receipt of your consent to verify that you fullyunderstand what it is you are consenting to and that all your questions have been answered.

Signature ____________________________________________________________________________

Date ____________________________________________________________________________


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Medical Information Please ensure all Sections are fully completed before returning to Cells4Life. Cells4Life will be unable to provide an umbilical cord blood collection kit until we are in receipt of this form. Name of doctor:

Address:

Planned delivery method: Caesarean / Normal (delete as appropriate)

Please answer the following questions to the best of your knowledge providing details in the Comments section below for any question(s) you may have answered Yes.

Section 1 – General Health Yes No 1. Are you in good health?

2. Are you taking any prescribed medicines, tablets or other treatments?

3. Have you experienced any unexplained fevers?

4. Have you had any recent vaccinations and/or dental treatment? If you have answered yes, please provide date(s) and specify vaccination(s) and/or treatment:

5. Have you previously been told not to give blood? If you have answered yes, please specify why:

Section 2 – Medical History Yes No 6. Have you ever had any form of cancer/malignant disease?

7. Do you or a blood relative have Creutzfeld-Jacob Disease (CJD)?

8. Have you ever been treated with extracts derived from pituitary glands or been a recipient of dura mater or corneal grafts?

9. Are you diabetic? If you have answered yes, please indicate whether this is type 1, type 2 or gestational:


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11. ;<"-$# %&'#( 3#4,'(*µ/, $-$,.&=, $581#0 *$- -.$(& *-0, *$, 15/*91, ! !2 *$, *:µ-, 2 ,1,(->21,$# 1#5(1,<+*+ -(*?+$(%20 1,. *.µ1#5()4-3# '-$5.12*#$# $+' #1(>#5µ<>- *-0 $,.0 $#4#.$-<,.0 12 µ2'#0;

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10. Have you ever injected yourself or been injected with illegal and/or non-prescribed drugs including cosmetics and body-building drugs?

11. Have you had acupuncture, a tattoo, your ears, face or body pierced, or any cosmetic treatment that involved piercing your skin in the past 12 months?

12. Does your family have a history of: a. inherited blood disorders?

b. any other inherited disorders?

13. Have you tested positive for HTLV or think you may be HTLV positive?

14. Have you tested positive for HIV or think you may be HIV positive?

15. Have you ever had Hepatitis B and/or Hepatitis C or think you may have Hepatitis B and/or Hepatitis C now?

If you have answered yes, please provide date(s) and latest test results:

16. In the last 12 months have you had sex with anyone who is, or you think may be HIV positive or anyone with, or who you think may have Hepatitis B or

Hepatitis C?

17. Have you ever had a sexually transmitted disease? If you have answered yes, please provide date(s) and specify disease:

18. Have you ever had jaundice? If you have answered yes, please indicate whether this is gestational:

19. Have you ever had tuberculosis?

20. Have you ever had an organ transplant? If you have answered yes, please indicate which type of transplant:

21. Have you ever had a xenotransplant or xenograft? If you have answered yes, please provide date(s):


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22. Have you ever received a blood transfusion? If you have answered yes, please provide date(s) and frequency:

23. Do you suffer epilepsy? If you have answered yes, please specify the length of time off treatment without an attack:

24. Has this pregnancy been conceived using donated eggs and/or sperm? If you have answered yes, please provide further information:

Yes No

25. Have you travelled outside the UK in the 6 months prior to your due date? If you have answered yes, please list destinations(s) visited below:

26. More specifically, have you returned from Greek Macedonia, North America, including Canada, and/or any other destination where the West Nile Virus was a threat in the 6 months prior to your due date? If you have answered yes, please list destinations(s) visited and date(s) returned below:

Section 3 – Travel History

27. During your visit to any of the destinations specified in questions 25 and 26, were you bitten by a mosquito?

28. If you have answered yes to question 27, have you had any symptoms of West Nile Virus infection, either during your stay or within 4 weeks of your return?

29. Have you received a diagnosis from a doctor of this virus?

30. Have you visited an area where malaria is prevalent in the last 12 months? If you have answered yes, please list destinations(s) visited below:

31. Have you ever had malaria or an unexplained fever associated with travel?

(e.g. fever, headache, tiredness, body aches, skin rash (on the trunk of the body) and swollen lymph glands, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis)


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