Completing your registration with CordBank

Registration Form

Registration via Email

Mother's Details

Name(Required)

First Last

Email(Required)

Phone(Required)

Date of Birth

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Father's Details

Name(Required)

First Last

Email(Required)

Phone(Required)

Pregnancy Details

Birth type(Required)

Single

Multiple

Due Date(Required)

Planned mode of delivery(Required)

Natural

Caesarean

Lead Maternity Carer's Name:(Required)

First Last

Lead Maternity Carer's Phone Number(Required)

Where are you having your baby?(Required)

Additional Contact Details

Please supply the details of a friend or relative who has consented to our keeping their details for contact purposes. CordBank will use this information only if we need to contact you or your child in the future. This must be someone who does not live with you.

Contact's Name(Required)

First Last

Contact's Phone

Contact's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Updates on Cord Blood Uses

Stay Updated

Yes, I would like to receive updates on new uses for cord blood from time to time.

CordBank Terms and Conditions / Parental Consent

Cord blood processing and storage contract

This contract concerns the processing, storage and care of cord blood taken from your child’s umbilical cord. This service will be supplied by CordBank on the terms below. Because of the nature of the service, CordBank and parents must carry out obligations.
Please read this document carefully. It is a legal document, which sets out the rights and responsibilities of the parents of the child, any persons who agree to underwrite payments to CordBank, and CordBank.

1.	Who are the parties to this contract?
•	CordBank Limited, which supplies processing and services with respect to cord blood. CordBank is referred to in this contract as “CordBank” or “we”;
•	The Parents who must give consent and make it possible for CordBank to collect, test and store cord blood. Where both parents enter into this contract they are jointly and severally liable for all payments and other obligations arising under this contract, but we may act on instructions or notices given by either parent without the other.  Parents are referred to as “you” in this contract;
•	The Sponsor who takes responsibility for making initial and ongoing payments to CordBank for the processing and storage of the cord blood. The Sponsor may elect to be primarily responsible for all payments, or to be responsible for all payments only if the parents fail to make them in a timely manner. It is not necessary for there to be a Sponsor. Parents (or the adult child) may choose to introduce a Sponsor at any time.

After your child reaches the age of maturity, they may decide to take over the rights and responsibilities of their parents by contracting directly with CordBank.
Until your child does this, they will have no rights or responsibilities directly under this contract, although other laws are likely to give your child rights with respect to the storage and disposal of their cord blood and the use of their personal information.

2.	How long does this contract run?
This contract will operate for a minimum term of 18 years unless one of the events occurs which will cause it to end earlier, as set out in paragraph 13. During that time, there are some important events you need to be aware of:
•	Before your child’s birth, parents must carry out the responsibilities set out in paragraph 6, to prepare for the collection of the cord blood.
•	Immediately after your child’s birth, parents must arrange for the cord blood to be collected and delivered to CordBank. CordBank will test the blood, and providing it is suitable for storage, will process it for storage. Your rights and responsibilities during this period are set out in paragraph 7.
•	On termination of this contract, unless the cord blood has been retrieved for use as set out in paragraph 9, or unless parents or the adult child enter into a new contract with CordBank, CordBank will dispose of the cord blood as set out in paragraph 13 or arrange for the cord blood to be returned to the family on payment of agreed reasonable costs to cover Lab time, admin and courier fees. 
•	During the term of the contract, you will need to make payment for CordBank’s services as set out in paragraphs 8 and 10. In summary:
•	Before your child’s birth, you must:
1.	pay the $2,100.00 registration fee in full
2.	or pay the $145 deposit in full and agree to pay the balance of the fee in monthly instalments over 6 or 12 months – (in accordance with the payment plan you selected when registering.)
3.	Your obligation to pay the whole of the registration fee (being $2,100.00) arises as soon as you register with CordBank. The full registration fee will be refunded only in circumstances where paragraph 7 says it will be refunded. The deposit of $145.00 will not be refunded.
•	During the remainder of this contract, CordBank will store the cord blood provided its storage fees are paid, as set out in paragraphs 8 and 10.

3.	 The law affecting this contract
New Zealand law will apply to this contract. This contract is based on New Zealand law as it is at the time of drafting. Because it is a long-term contract, the New Zealand law which affects parties’ rights and duties during the contract will probably change. Some of these law changes may override terms of this contract. Where it is necessary to interpret clauses of the contract in the light of new law, then the interpretation will be carried out in accordance with the spirit and intention of this contract.

4.	 Parental consent
While children are minors, a parent or guardian has the right to consent to the collection, storage, use, disposal or return of their child’s cord blood. CordBank does not own the cord blood.
You must confirm you accept the Parental Consent Form which forms part of this contract.

5.	 Child’s consent
When your child is of age and able to give consent, only they will be able to give consent to the use, disposal or return of the cord blood, as set out in paragraph 9. Your child’s consent must be informed consent. You must undertake to give your child all the relevant information, including information that we send you for your child, to enable them to give informed consent.
At the time you enter into this contract, the age of informed consent to healthcare procedures is 16 years.

6.	 Before your child is born
What you must do first:
As soon as possible (and no less than 14 days before the expected birth date):
(a)	Register your child with CordBank, and provide all necessary information;
(b)	Provide the required information and sign all consents as set out in this contract;
(c)	Pay the registration fee option you have chosen in full;
(d)	Either pay the registration fee in full or agree to pay it in monthly instalments over 6 or 12 months – (in accordance with the payment plan you selected when registering.)
(e)	Tell your Lead Maternity Carer (“LMC”) that you intend to collect a cord blood sample and a blood sample from the mother for testing. Your LMC is not CordBank’s agent. Your LMC collects your baby’s cord blood at your request and is solely responsible to you for the performance of that task.
(f)	If you require an independent collector, someone other than your LMC, to collect cord blood at your delivery, you accept that the independent collector collects your baby’s cord blood at your request and is solely responsible to you for the performance of that task. An independent collector is required if your LMC is not available or does not want to collect cord blood on your behalf. The independent collector (Third Party Collector) must be a registered health professional that has completed the necessary training in order to collect cord blood. They are not contracted to CordBank. It is your responsibility to contact the Independent Collector as per the advice provided by CordBank to you. As your health and the wellbeing of you and your baby is paramount, the LMC delivering your baby will have the final say as to whether the collection is carried out. You agree that you will call CordBank on 0800 CORDBANK if you have any questions regarding this process.
(g)	Email us about any changes in your contact details and delivery plans (if you have registered earlier), including any change in LMC.
(h)	Set up arrangements to pay us the fees payable under this contract (including the Annual Storage Fee) by credit card or debit card payment. Failure to keep those arrangements in force is a breach of this contract which can lead to us terminating this contract.

If you are having a multiple pregnancy (twins, triplets, etc.) you will need to pay a further registration fee as each child will need a separate cord blood collection kit. Registration fees and storage fees will be required for each child.

Remember that your LMC is the person who makes the decision, immediately after birth, to collect the cord blood. They may decide that it is not in the best interests of the mother or child to do so. In that case, you agree that you understand that your LMC’s decision will be final and that neither we nor they will be liable to you or any other person in any way for that decision.
What we will do:
(a)	Send you a cord blood collection kit including all the equipment necessary to collect both the cord blood and a sample of maternal blood, and a return courier bag so you can arrange for the collection kit to be returned to CordBank;
(b)	Send instructions within the CordBank collection kit for your LMC.
(c)	Arrange specific cord blood collection training for your LMC. An LMC must be trained by CordBank for them to be able to collect at your delivery.
(d)	On your behalf, arrange for a contracted courier to be available to receive your call and transport the cord blood to CordBank after it is collected. CordBank will pay the standard courier fee on your behalf. 
(e)	Provide a 24-hour free phone helpline for you and your LMC.

What you must do next:
(a)	Email us within three working days of confirmation of your registration, if you have not received the CordBank Collection Kit;
(b)	Take with you to the hospital or birth centre the CordBank Collection Kit, which includes the LMC instructions and courier collection bag.

WARNING: You must not open the CordBank Collection Kit, as your LMC will not be able to use it.

7.	 When your child is born
What you must do:
(a)	Ask your LMC to collect as much as possible of your child’s cord blood and a sample of maternal blood, according to the Lead Maternity Carer Information Sheet (SOP404-02 V03).  
Remember that your LMC has the final say as to whether this is done, as the safety of mother and child comes first. If they are unable to collect the cord blood this contract will terminate, and we will refund the registration fee or any part of it that has been paid except for $145.00. 
Contact the contracted courier within 90 minutes of the collection of your baby’s cord blood to arrange for both blood samples to be couriered to CordBank, in the container provided, to arrive at CordBank’s premises within 30 hours after the birth of your child.
(b)	Be careful to tell the courier exactly where to pick up the sample. If you are out of Auckland, the courier may need to arrange air transport and will need as much notice as possible. If the sample is incorrectly packaged, arrives late or is damaged in transit, CordBank may not be able to process or store it. Ring 0800 CORDBANK (0800 267 322) if you are aware of any problems or need advice.

What we will do:
(a)	Receive the blood samples at our premises and label them with your child’s unique identifier.
(b)	Test the maternal  blood for infectious diseases.
(c)	Pay your LMC a fee for collecting the cord blood for your child.
(d)	Call you to let you know the cord blood has arrived.

If the blood arrives too late, is damaged, or if there is too little to be stored or if, in our opinion, the cord blood is unsuitable for storage for any reason at all, we will not process it any further and we will dispose of both the maternal sample and the cord blood immediately and safely. We retain the sole right to make this decision. If this happens, we will contact you. We will also refund the registration fee or any part of the fee that has been paid, except for $145.00, and this contract will terminate.

If the maternal sample tests positive for infectious diseases such as HIV, Hepatitis B or C, or Syphilis, no refund will be given, and cord blood will be disposed of immediately because of the risk of infection. Before having an HIV test you may wish to see a counsellor to consider the implications of the test results. The cost of HIV counselling is not included in the CordBank service. If your result for infectious diseases is positive, CordBank will contact you directly.

8.	 Processing and storage
What we will do:
(a)	We will arrange processing of the cord blood for cryogenic storage.
(b)	We will keep the cord blood in cryogenic storage, for the remainder of the term of this contract.
(c)	Unless you have prepaid the registration fee, we will charge your credit card every month for 6 or 12 months following payment of the deposit as set out in paragraph 10.
(d)	Unless you have prepaid this contract for 18 years, we will charge your credit card for the storage fee every year in the month your child was born.
(e)	We will make all reasonable attempts to contact you if we have not received payment. However, if for any reason:
i.	any part of the registration fee is still unpaid 90 days after it was due to be paid; or
ii.	The annual storage fee is still unpaid 90 days after your child’s birthday, whether or not we have been able to contact you or the Sponsor, we will terminate this contract as set out in paragraph 13.

What you must do:
(a)	Make sure the registration fee instalments are paid on time if you have not paid it in full.
(b)	Make sure the Annual Storage Fee is paid on time if you have not prepaid it.
(c)	Notify CordBank in writing of all changes in contact details: changes of name, address, telephone number, email address, and bank account or credit card number.
(d)	Keep us up to date with the addresses of all contact people shown on the information sheet.

9.	 Retrieval of the sample for use
This section sets out what we intend to happen if the cord blood is needed for your child. You should be aware that exactly what happens will be defined by current law and medical practice at the time and may differ from what is described here.
CordBank will only release your child’s cord blood to a registered medical practitioner who acknowledges in writing that he or she is proposing to use the cord blood for your child. Before releasing your child’s cord blood, CordBank will require your consent, or the consent of your adult child, and the written acknowledgment from the registered medical practitioner.
 
What you must do:
(a)	Contact CordBank immediately for a consent form, also giving the name of the registered medical practitioner who is requesting the cord blood. We will require an acknowledgment in writing from the registered medical practitioner that they are proposing to use the cord blood for your child.
(b)	Give your written consent, or, if your child is over the age of consent at the time and can consent, procure the written consent of the Child.
(c)	You will be responsible for arranging collection of the cord blood sample for delivery to the destination requested by the medical practitioner and confirming instructions to CordBank.

What we will do:
(a)	Make cord blood available for shipment at the request of the registered medical practitioner after receiving their acknowledgement in writing that they are proposing to use the cord blood for your child.
(b)	If you have prepaid any annual storage fee, refund to you on a pro rata basis any prepaid annual fee for each whole year after the year in which the request is made.
Note: Under New Zealand law and Ministry of Health regulations, we   may be required to refuse to deliver the cord blood to your instructions if they involve:
i.	transferring possession to a person who is not a registered medical practitioner;
ii.	use of the cord blood for a purpose which is:
•	illegal, or
•	not a therapeutic purpose permitted by New Zealand law, or
•	not in accordance with best medical practice, or not in the best interests of your child in accordance with accepted New Zealand medical ethics practice, or 
•	if we are required by law to refuse

10.	Payment terms
You agree to make all the following payments:
(a)	The deposit of $145 .00 must be paid at the time of registration before your child is born.
(b)	The registration fee must be paid either:
1.	as a one-off payment at the time of registration, or
2.	in instalments every month for 6 months following payment of the initial deposit, or
3.	in instalments every month for 12 months following payment of the initial deposit.
(c)	Annual storage fees. These must be paid annually in advance in full and in one amount. Each payment must be made on the first day of the month in which your child was born. If you have cord blood stored for more than one child, a separate annual storage fee is payable for each child on the appropriate date; and 
(d)	Any other special costs as set out in this contract.

If you choose to pay the balance of the registration fee in monthly instalments following registration, payments will be debited from your credit card or bank account 30 days after you have paid the initial deposit and will continue until the balance is paid.
CordBank may increase the annual storage fee at any time after the third anniversary of the date of this contract, or where GST changes are required by law. We will notify you of any increase at least 30 days before your child’s birthday each year, and this will apply to any annual storage fee which has not already been prepaid.
It is your responsibility to make sure that your credit card issuer or your bank pays us. Payment is not made until funds have cleared into our bank account. You agree that if any payments are not made by you, or payments are dishonoured or reversed, you will pay all costs of dishonour and all costs of debt collection including legal costs on a lawyer/client basis.
Where a Sponsor has agreed to underwrite payments, you are still primarily liable for payments under this contract, and if the Sponsor fails to make any payments, CordBank can require you to make those payments or terminate this contract as set out in paragraph 13.
Except as required by law, we will make refunds to you (or, if the Sponsor has made those payments, to the Sponsor) only as set out in this contract. If someone other than you or the Sponsor has made the payments, it is your responsibility to reimburse that person and we will not be liable to them.
Our obligations and your obligations regarding payment on termination of this contract are set out in paragraph 13.

11.	Sponsor’s duties
If you choose to introduce a Sponsor, the Sponsor agrees to underwrite the payment of all money due and payable under this contract, in consideration of the services to be supplied for the benefit of the child.
Where the Sponsor has agreed with the parents to make those payments on their behalf at all times, the Sponsor agrees to be the party which is billed, and undertakes to make all payments directly to CordBank, without releasing the parents from their responsibility to make payments to CordBank.
Otherwise, the Sponsor acts as guarantor and underwriter for all payments due under this contract, and agrees that, if at any time any payment remains unpaid for a period of 90 days, then he or she will be directly liable to CordBank for all outstanding and future payments, any right of reimbursement from the parents being strictly between the Sponsor and the parents. The Sponsor acknowledges that CordBank will terminate this contract if he or she fails to make those payments. You, or your adult child, always remain responsible for decisions about the storage of your child’s cord blood.
The Sponsor may assign his or her responsibilities under the Contract but only if CordBank agrees in writing. CordBank will not unreasonably withhold consent.

12.	Extending this contract
When your child reaches the age of 18, this contract will continue in force (subject to the right to terminate under clause 13), unless you, the child, the Sponsor, or CordBank terminates this contract by 90 days notice in writing. Any such notice may be given before your child’s 18th birthday, but no such termination will be effective (which means fees will continue to accrue and be payable under this contract) unless by the effective date of termination all amounts due and unpaid under this contract up to that date have been paid in full and you, the child or the Sponsor have completed and signed such additional documentation as CordBank may require.

13.	Termination of this contract for any reason
This contract will terminate if:
(a)	Your LMC is unable to collect the cord blood or if the cord blood sample is found to be unsuitable for storage, as set out in paragraph 7.
(b)	Your child reaches the age of 18 and refuses to consent to an extension of this Contract as set out in paragraph 12.
(c)	Either you or your adult child and the medical practitioner providing treatment, requests us to deliver the cord blood for use as set out in paragraph 9.
(d)	CordBank or you terminate this contract by either CordBank or you giving the other 90 days notice in writing.
(e)	Both you and the Sponsor (if any) fail to pay any amount due under this Contract, and that payment is still unpaid 90 days from the date it was due.
(f)	You fail to keep in effect arrangements to pay fees by an electronic method, as required by paragraph 6(h).
(g)	The cord blood sample is lost or destroyed under any circumstances.

On termination of this contract:
(a)	We will make reasonable attempts to contact you and advise you (or your adult child) of options available at the time for disposal or return of the cord blood in accordance with current legal and medical practice at that time.
(b)	We will carry out your lawful instructions for disposal or return of the cord blood, provided your instructions are given, and you pay in advance for the reasonable costs of us doing this, within 30 days of the date we have contacted or attempted to contact you.
(c)	If we cannot contact you, the Sponsor or the additional contact within 30 days after reasonable attempts to do so, or if you provide no instructions as to disposal or return of the cord blood, or if you or the Sponsor fail to pay the costs of return or disposal within 30 days of the date, we have contacted you, we will dispose of the cord blood in a manner of our choice and in accordance with current legal and medical practice at that time.
(d)	If your LMC is unable to collect the cord blood or if the cord blood is found to be unsuitable for storage as set out in paragraph 7, and this contract terminates, you will not be entitled to a refund of the deposit of $145.00. However, we will refund any part of the registration fee that has been paid above this amount, unless the last paragraph of paragraph 7 applies.
(e)	If the contract is terminated for any other reason, you will not be entitled to any refund of the registration fee or the processing fee or the annual storage fee paid to date and if the processing fee has not been paid in full at the time of termination, you will be required immediately to pay any balance of the processing fee outstanding.

For the purposes of this contract, we will have made reasonable attempts to contact you if we have posted a letter to the address we hold for you, and waited for 10 days after that, or sent an email to the email address we hold for you and waited for two days after that.

14.	What if I change my mind after I have registered?
The registration deposit of $145.00 cannot be refunded after the cord blood kit has been issued to you – whether you have changed your mind or are unable to proceed with cord blood storage. We will refund any part of the registration fee paid only in the circumstances recorded in paragraph 7.

15.	How we carry out our services
We may use contractors to carry out any or all our services including storage of the cord blood. The choice of contractors is entirely at our discretion, provided we and they work within the medical and governmental guidelines which apply at the time.
We can assign this contract and all of our obligations under it to another service provider, as long as that provider is properly licensed to carry out its duties under this contract, and if we do assign, we will be released from our obligations to you.

16.	Our liability to each other
Your LMC or independent collector is not CordBank’s agent. Your LMC or independent collector collects your baby’s cord blood at your request and is solely responsible to you for the performance of that task.
Nevertheless, this liability provision also applies for the benefit of your LMC or independent collector (collectively referred to below as ‘LMC’).
Provided we or your LMC have acted in good faith, with reasonable care and skill and in accordance with current legal, ethical and medical practice during the term of this contract;
(a)	CordBank, your LMC, and our and their employees, directors, agents, and contractors, will never be liable for any loss or damage of any kind whatsoever which arises in relation to the performance of this contract as a result of decisions, actions or inactions which you, your child or the Sponsors have made or carried out. You indemnify all of us against all costs, losses and damages (including legal costs on a solicitor-client basis) arising from claims of any kind in respect of those decisions, actions or inactions;
(b)	CordBank, your LMC and our and their employees, directors, agents, and contractors will not be liable for the failure of any medical procedure (including failure of engraftment of the cord blood cells) or in respect of any matters which do not form part of any service supplied by CordBank.
CordBank, your LMC and our and their employees, directors, agents, and contractors, will not be liable to you or any other person for the consequences of events beyond our or their control.
You and your child may have other rights under the Consumer Guarantees Act 1993. But to the fullest extent of the law, we will not be liable to you or any other person for any loss or damage of any kind whatsoever, including personal injury or failure of medical procedures, which occur in connection with our supply of goods and services to you.
If there is a dispute as to any matter addressed by this agreement which cannot be resolved by the parties, the matter shall be referred to a mediator appointed by the chairman of the Auckland chapter of LEADR, with the parties agreeing to bear their own individual costs and to share the cost of mediation equally. 
Any mediation will take place in Auckland. Subject to the next sentence, no party may commence any other form of dispute resolution proceedings (including in any court or the Disputes Tribunal of New Zealand) until mediation has been completed. However, that does not prevent any party from seeking urgent interlocutory relief or a declaratory judgement on a point of law.

17.	Changes to this contract
We can change the terms of this contract by notifying you of those changes in writing by post or email to the last postal or email address you have given us. We may notify you by directing you to the CordBank website for details of the changes. If we do, it is your responsibility to check the website. Except for changes required by law, or in the circumstances set out elsewhere in this contract, we will give you 30 days’ notice of any changes.
From time to time, CordBank may make promotional offers. The terms of those offers will be as set out on the CordBank website and will amend the terms of this contract to the extent shown on the website.

18.	Personal information
CordBank will hold in confidence all personal information it needs for carrying out services. Every person has the right of access to their personal information, and to ask for correction of that information.
We will use and disclose that information only according to the principles of the NZ Privacy Act 2020 and any codes under that Act. We may be required to disclose that information by law.
We cannot disclose information in response to a telephone enquiry unless we are provided with:
•	The name and date of birth of your child;
•	Your name;
•	Such confirmation of identity and authorisation to receive the information as we may reasonably require.
 
 
Parental consent form

1.	For the client to complete and return to CordBank
On behalf of our unborn baby, and ourselves, we wish to apply for the individual cord blood storage service offered on behalf of our child, who is yet to be born. We  undertake that when our child becomes old enough to give their own consent to these terms, we will supply our child with all the information supplied to us by CordBank at that time, (including this form) to enable our child to make an informed decision.

2.	This consent agreement conveys that we fully understand the following:
(a)	That the individual service offers storage for blood cells contained in cord blood. The samples will be uniquely identified, stored and maintained at a cryogenic storage facility. CordBank will retrieve these cells at the request of a registered medical practitioner with consent provided by us or our adult child in accordance with the terms of the Cord Blood Processing and Storage Contract.
(b)	That if the mother fails screening procedures (including testing for HIV, Hepatitis B or C or Syphilis) or in CordBank’s opinion the cord blood is unsuitable for storage for any reason at all, the baby’s cord blood will be ineligible for storage.

3.	Collection of cord blood
We understand that:
(a)	It is not possible to determine whether our child will develop a condition or disease in the future which can be treated by these cells. However, collecting and storing our baby’s cord blood cells may benefit our baby should they need them in the future to treat certain conditions or diseases.
(b)	These cord blood cells are a perfect match with our baby and while there is no guarantee our baby will ever need them, the fact that they are a perfect match can reduce serious complications should stem cell therapy ever be needed.

(c)	There is a possibility that our baby’s cord blood stem cells may be suitable for use for the treatment of other family members. Whether this can be done will depend on the law at the time of need.
(d)	Complications can arise at birth, and it may not be possible or prudent for our lead maternity carer or independent collector to collect the cord blood. Collection of cord blood can therefore not be guaranteed. The mother’s health and the health of our baby is our lead maternity carer’s chief priority. We agree that our lead maternity carer’s judgement shall be absolute and final.

4.	Receipt and processing of cord blood
We understand that:
(a)	The cord blood sample will be processed on receipt by CordBank, and the fees incurred as per the CordBank Ltd Cord Blood Processing and Storage Contract.
(b)	There is no way of knowing if the cord blood sample can be stored until it is processed and assessed at CordBank’s laboratory. CordBank maintains the right to reject any cord blood sample if it arrives too late, is damaged, there is too little to be stored, the maternal blood tests indicate the presence of HIV,  Hepatitis B or C or Syphilis or if, in our opinion, the cord blood is unsuitable for storage for any reason at all. If the blood sample is rejected, CordBank will take all reasonable steps to contact me regarding the destruction of the sample.

5.	Infectious disease tests on maternal blood
The mother agrees to provide a vial of her blood at the time of birth. This blood will be tested for HIV, Hepatitis B antigen and Hepatitis C antibodies and Syphilis. CordBank will use this information for the sole purpose of determining the suitability of the cord blood sample for storage. CordBank will not disclose this information to any person other than the mother (including the baby’s other primary parent) without the mother’s written authorisation.

6.	Other alternatives
We understand that other sources of stem cells exist, including bone marrow and peripheral blood, and that stem cells harvested from these sources have been used successfully to treat the same diseases. In the future, other ways of treating these diseases may be found, so that these cord blood cells may not be useful.
While bone marrow is currently the most common source of stem cells, collecting stem cells from bone marrow, requires an invasive procedure and carries the risk of infection and surgical complications. Should a stem cell donor be needed later, finding a suitable match can be lengthy or unsuccessful.

7.	Storage of cord blood cells
We understand that the freezing and storage process used to preserve cells harvested from cord and placental blood is similar to the process that is currently used for storing other human cells, and that although this freezing technique has been used for many years to successfully preserve bone marrow and other blood cells, it has only been used to store cord blood stem cells for the past 35 years.
Laboratory studies and transplants utilising frozen stem cells suggest that this process can be used successfully with cord blood cells. We consent to the cord blood being stored for the minimum term of the contract, but there is always a risk that stem cells will not be viable after removal. We accept that risk.

8. Use of cord blood
We understand that cord blood stem cells have been used to successfully treat diseases such as certain cancers and blood disorders. Potential risks include the possibility that this type of treatment may not be effective. We understand that cord blood cells are not the treatment of choice for all diseases or conditions and that should the need arise, the decision to use the cord blood cells stored under the individual account is strictly between us (or our adult child) and our doctor. It is possible that in the future better therapies may be developed.
We certify that we have read this consent form and the information provided to us by CordBank, including the Cord Blood Processing and Storage Contract. Any questions have been answered to our satisfaction. I acknowledge that under the contract CordBank may:
(a)	increase the annual storage fee after the third anniversary of the date of the contract;
(b)	terminate the contract at any time by 90 days notice to me; and
(c)	change the terms of the contract at any time by 30 days’ notice to me.

A promise 
to our child
•	We promise that we will show this form to our child when they are old enough to give informed consent.
•	We promise that we will also give our child any information supplied to us by CordBank to update the information which is available to us.
•	We promise we will help our child to get independent advice if necessary, to help them give informed consent to the continued storage of their cord blood.
•	We promise that, if our child chooses to continue to save their cord blood stored by CordBank, we will pay for continued storage until our child is financially able to pay for it.
V0521 June 2021

Agreement(Required)

Yes, I have read and accept the CordBank Terms and Conditions and Parental Consent Form.