ex4-1.htm


    Exhibit 4.1

     

    


     

    SUBSCRIPTION
AGREEMENT

    


    Gemini
Tea Corp.

    13836
Parkland Blvd SE

    Calgary,
Alberta

    Canada
T2J 3X4

    


    The
undersigned has received the prospectus dated __________, 2010 (the
“Prospectus”), and hereby subscribes for _____________ shares of $.0001 par
value common stock of Gemini Tea Corp., a Nevada corporation (the “Company”),
for a subscription price of $0.10 per share (the “Offered
Shares”).  The undersigned hereby agrees that this subscription shall
be irrevocable and shall survive the death or disability of the
undersigned.  Payment of the purchase price for the Offered Shares is
due upon subscription.

    


    The
undersigned acknowledges that (i) the Company has the right to accept or reject
this subscription in whole or in part, (ii) this subscription shall be deemed to
be accepted by the Company only when the Company signs this Subscription
Agreement; and (iii) the undersigned has relied only on that information
specified in the Prospectus.

    


    Number of
Offered Shares: _________________.  Subscription Amount: ___________
(number of Offered Shares multiplied by $0.10)

    


    Make
check payable to:  Gemini
Tea Corp.

    


    Please
print name(s) or title, residence address, and SSN or Tax ID for which the
Offered Shares are to be registered.  Please notify the Company in
writing if your address changes before you either receive your shares or are
notified that your subscription has not been accepted.

     

    
      	
              Name

            	 
      	 
      	 
      	 
      	 
	
              Street

            	 
      	 
      	 
      	 
      	 
	
              City

            	 
      	
              State

            	 
      	
              Zip
      Code

            	 


    

    SSN
or Tax ID No. (For joint ownership, both parties must provide a Social Security
Number or similar tax  identification)

    


    Indicate
type of ownership:

    


    
      	
                 
      o

            	
                Individual
      Ownership

            	
                 
      o

            	
                Joint
      Tenants with Right of Survivorship

            
	 
      	 
      	 
      	 
      
	
                 
      o

            	
                Community
      Property

            	
                 
      o

            	
                Tenants
      in Common

            
	 
      	 
      	 
      	 
      
	
                 
      o

            	
                Tenants
      by the Entirety

            	
                 
      o

            	
                Corporate
      Ownership

            
	 
      	 
      	 
      	 
      
	
                 
      o

            	
                Partnership
      Ownership

            	
                 
      o

            	
                Custodian
      for a Minor

            
	 
      	 
      	 
      	 
      
	
                 
      o

            	
                Trust
      (see below)

            	
                 
      o

            	
                IRA
      or Pension Plan

            


    

    


    Date
Trust Established:                                              

    Name of
Trustee or other Administrator                                     

    


    


    
      
        
        

      

      
        -1-

        
          

        

      

      
        
        

      

    

    Each
subscriber represents that:

    


    
      	
              (a)  

            	
              The
      information contained herein is complete and accurate and may be relied
      upon, and

            


    

    


    
      	
              (b)  

            	
              The
      undersigned will notify the Company immediately of any material change in
      any such information occurring prior to the acceptance of the
      undersigned’s subscription, including any changes in address or other
      contact information.

            


    

    


    IN
WITNESS WHEREOF, the undersigned has executed this Subscription Agreement as of
this ______ day of ____________ 2010.

    


    FOR
INDIVIDUALS:

    


    
      	 
      	 
      	 
      	 
      	 
      
	
              Print
      Name

            	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      
	
              Signature

            	 
      	 
      	 
      	 
      


    

    


    NAME
AND SIGNATURE OF JOINT TENANT OR TENANT IN COMMON

     

    
      	 
      	 
      	 
      	 
      	 
      
	
              Print
      Name

            	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      
	
              Signature

            	 
      	 
      	 
      	 
      


    

    


    FOR
TRUSTS, CORPORATIONS, PARTNERSHIPS

     

    
      	 
      	 
      	 
      
	
              Print
      Name of Entity

            	 
      	 
      
	
              By:      

            	 
      	 
      
	
              Print
      name and capacity (Trustee, President or General Partner) of person making
      investment decision

            


       

      
        
          
          

        

        
          -2-

          
            

          

        

        
          
          

        

      

      	 
      	 
      	 
      
	
              Signature

            	 
      	 
      


    

    
Agreed to
and accepted:

    


    By: Gemini Tea
Corp.,

    a Nevada
corporation

     

    By: _____________

    Wanda
Canning

    Its:
President

     

     

    


    
      
        
        

      

      
        -3-