SEC Filings

[ * ] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.

Hereby declare that I agree to participate in the medical experiment that is described in this document.

2.

I declare that at the time of signing this document, I do not participate in any other experiment that requires any usage of any other drug/ or product, and I declare, commit and promise that I will not participate in any other medical experiment during the period of time of this experiment.

3.

I declare that I was informed by ____[name of the researcher] that:

a)

The Leading Researcher is Professor Binyamin Reubinoff, received an approval form the CEO of the Institution to perform this experiment on human beings, as described in the Israeli Public Health Regulations -1980.

b)

The Leading Researcher is affiliated with the Initiator of the experiment. Leading Researcher is Professor Binyamin Reubinoff.

c)

The subject of the experiment is: Producing of connective tissue cells from the umbilical cord remnant obtained after birth, for their usage in research and development of embryonic stem cells of a human being. Protocol Number: [ * ]

d)

I am free to choose not to participate in the medical experiment, and I’m free to choose to leave the experiment and to terminate my participation in the experiment at any time I choose, and this is without jeopardizing my right to receive the appropriate medical treatment.

[ * ] = Certain confidential information contained in this document, marked by brackets, has been omitted and filed separately with the Securities and Exchange Commission pursuant to Rule 24b-2 of the Securities Exchange Act of 1934, as amended.