Document:

Exhibit
4.1

 

THE
SECURITIES REPRESENTED HEREBY, INCLUDING THE SHARES ISSUABLE UPON EXERCISE HEREOF, HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED (THE "ACT"), OR ANY STATE SECURITIES LAWS AND NEITHER THE SECURITIES NOR ANY INTEREST THEREIN
MAY BE OFFERED, SOLD, TRANSFERRED, PLEDGED OR OTHERWISE DISPOSED OF EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER
SUCH ACT OR SUCH LAWS OR AN EXEMPTION FROM REGISTRATION UNDER SUCH ACT AND SUCH LAWS WHICH, IN THE OPINION OF COUNSEL FOR THE
ISSUER, IS AVAILABLE.

 

WARRANT
AGREEMENT

 

healthlynked
corporation

 

This
Warrant Agreement (this “Agreement”) is dated as of _____________ (the “Issue Date”) and
entered into by and between HealthLynked Corporation, a corporation organized under the laws of State of Nevada and Michael
Dent, (together with its successors and assigns, the “Warrant Holder”).

 

WHEREAS,
the Warrant Holder loaned $439,950 to the Corporation between January 1, 2017 and February 5, 2018 in the form of unsecured promissory
notes on terms more favorable to the Corporation than loans made by unrelated third parties to the Corporation during the same
period; and

 

WHEREAS,
the Company is entering into this Agreement as an inducement for the Warrant Holder to make additional loans in the future on
similar Company-favorable terms; and.

 

NOW,
THEREFORE, in consideration of the mutual covenants set forth in this Agreement and for other good and valuable consideration,
the parties agree as follows:

 

1.           Grant
of Warrant. The Company hereby, upon the terms and subject
to the conditions of this Agreement, issues to the Warrant Holder a warrant (the “Warrant”) evidenced by this
Agreement to purchase up to 6,768,462 shares of Company common stock at an exercise price of $0.065
per share pursuant to the terms hereof (the “Exercise Price”).

 

2.          Term
and Termination of Warrant. The Warrant shall terminate
on the fifth (5th) anniversary of the Issue Date (the “Expiration Date”).

 

3.          Exercise
of the Warrant.

 

(a)         Exercise
and Payment. The purchase rights represented by the Warrant may be exercised by the Warrant Holder, in whole or in part at
any time following the Issue Date during the period prior to the Expiration Date, by the surrender of the Warrant (together with
a duly executed notice of exercise in the form attached hereto as Exhibit A (the "Exercise Notice") at
the principal office of the Company, and by the payment to the Company, at the option of the Warrant Holder by wire transfer of
immediately available funds, of an amount equal to (A) the number of Warrant Shares being purchased upon exercise of the Warrant
multiplied by (B) the Exercise Price (the “Warrant Price”).

 

     

     

    

 

(b)        Warrant
Shares. On or before the first (1st) Business Day (as hereafter defined) following the date on which the Company
has received an Exercise Notice, the Company shall transmit by facsimile an acknowledgment or confirmation of receipt of such
Exercise Notice to the Holder. On or before the third (3rd) Business Day following the date on which the Company has
received such Exercise Notice, so long as the Holder delivers the Aggregate Exercise Price on or prior to the second (2nd)
Business Day following the date on which the Company has received such Exercise Notice, the Company shall issue and deliver to
the Holder or, at the Holder’s instruction pursuant to the Exercise Notice, the Holder’s agent or designee, in each
case, sent by reputable overnight courier to the address as specified in the applicable Exercise Notice, a certificate, registered
in the Company’s shareholder register in the name of the Holder or its designee (as indicated in the applicable Exercise
Notice), representing the number of Warrant Shares to which the Holder is entitled pursuant to such exercise. The Company shall
be responsible for all fees and expenses related to the issuance of such Warrant Shares, if any. Upon delivery of an Exercise
Notice, the Holder shall be deemed for all corporate purposes to have become the holder of record of the Warrant Shares with respect
to which this Warrant has been exercised, irrespective of the date of delivery of the certificates evidencing such Warrant Shares.
If this Warrant is submitted in connection with any exercise pursuant to this Section 3(b) and the number of Warrant Shares represented
by this Warrant submitted for exercise is greater than the number of Warrant Shares being acquired upon an exercise, then, at
the request of the Holder, the Company shall as soon as practicable and in no event later than three (3) Business Days after any
exercise and at its own expense, issue and deliver to the Holder (or its designee) a new Warrant (in accordance with Section 11(d))
representing the right to purchase the number of Warrant Shares purchasable immediately prior to such exercise under this Warrant,
less the number of Warrant Shares with respect to which this Warrant is exercised. Fractional shares of stock are to be issued
upon the exercise of this Warrant. The Company shall pay any and all taxes and fees which may be payable with respect to the issuance
and delivery of Warrant Shares upon exercise of this Warrant. Following the exercise in full of this Warrant, the Holder shall
deliver this original Warrant certificate to the Company. For purposes of this Warrant, “Business Day” means
any day other than Saturday, Sunday or other day on which commercial banks in The City of New York are authorized or required
by law to remain closed.

 

(c)        Company’s
Failure to Timely Deliver Securities. If the Company shall fail for any reason or for no reason to issue to the Warrant Holder
within five (5) Business Days of receipt of the Exercise Notice so long as the Warrant Holder delivers the Aggregate Exercise
Price on or prior to the second (2nd) Business Day following the date on which the Company has received the Exercise
Notice, a certificate for the number of Warrant Shares to which the Warrant Holder is entitled and register such Warrant Shares
on the Company’s shareholder register, then, the Warrant Holder is entitled to all remedies available to him Nothing shall
limit the Warrant Holder’s right to pursue any remedies available to it hereunder, at law or in equity, including, without
limitation, a decree of specific performance and/or injunctive relief with respect to the Company’s failure to timely deliver
certificates representing the Warrant Shares (or to electronically deliver such Warrant Shares) upon the exercise of this Warrant
as required pursuant to the terms hereof.

 

    	 	2	 

     

    

 

(d)        Fractional
Warrant Shares. Fractional Warrant Shares will be issued in connection with any exercise hereunder.

 

(e)        Legend.
The Warrant Shares to be acquired by the Holder pursuant hereto, may not be sold or transferred unless (A) such securities
are sold pursuant to an effective registration statement under the Securities Act, or (B) the Company or its transfer agent shall
have been furnished with an opinion of counsel (which opinion shall be in form, substance and scope customary for opinions of
counsel in comparable transactions and from an attorney who regularly practices securities law) to the effect that the securities
to be sold or transferred may be sold or transferred pursuant to an exemption from such registration or (C) such securities
are sold or transferred pursuant to Rule 144 under the Securities Act (or a successor rule) (“Rule 144”) or
(D) such shares are sold or transferred outside the United States in accordance with Rule 904 of Regulation S under the Securities
Act, or (E) such shares are transferred to an “affiliate” (as defined in Rule 144) of the Company who agrees to sell
or otherwise transfer the shares only in accordance with this Section 3(e). Except as otherwise provided in this Warrant (and
subject to the removal provisions set forth below), until such time as the Warrant Shares issuable upon exercise of the Warrant
have been registered under the Act, otherwise may be sold pursuant to Rule 144 without any restriction as to the number of securities
as of a particular date that can then be immediately sold, each certificate for Warrant Shares that has not been so included in
an effective registration statement or that has not been sold pursuant to an effective registration statement or an exemption
that permits removal of the legend, shall bear a legend substantially in the following form, as appropriate:

 

THE
SECURITIES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED. THE HOLDER
HEREOF, BY PURCHASING SUCH SECURITIES, AGREES THAT SUCH SECURITIES MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED ONLY
(A) TO THE CORPORATION, (B) OUTSIDE THE UNITED STATES IN ACCORDANCE WITH RULE 904 OF REGULATION S UNDER THE U.S. SECURITIES
ACT, (C) WITHIN THE UNITED STATES AFTER REGISTRATION OR IN ACCORDANCE WITH THE EXEMPTION FROM THE REGISTRATION REQUIREMENTS
UNDER THE U.S. SECURITIES ACT PROVIDED BY RULE 144 THEREUNDER, IF APPLICABLE, AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES
LAWS, OR (D) WITHIN THE UNITED STATES IN A TRANSACTION THAT DOES NOT REQUIRE REGISTRATION UNDER THE U.S. SECURITIES ACT OR
ANY APPLICABLE STATE SECURITIES LAWS AND THE HOLDER HAS PRIOR TO SUCH SALE FURNISHED TO THE CORPORATION AN OPINION OF COUNSEL
REASONABLY SATISFACTORY TO THE CORPORATION.

 

(f)        Removal
of Legend. The legend set forth above shall be removed and the Company shall issue to the Holder a new certificate therefor
free of any transfer legend if (A) the Company shall have received an opinion of counsel, in form, substance and scope customary
for opinions of counsel in comparable transactions, to the effect that a public sale or transfer of such Securities may be made
without registration under the Act and the shares are so sold or transferred, or (B) (C) in the case of the Conversion Securities
issuable upon exercise of the Warrant, such security is registered for sale by the Holder under an effective registration statement
filed under the Act or otherwise may be sold pursuant to Rule 144 without any restriction as to the number of securities as of
a particular date that can then be immediately sold. The Company shall cause its counsel to issue a legal opinion promptly after
the effective date of any registration statement under the Act registering the resale of the Conversion Securities issuable upon
exercise of the Warrant if required to effect the removal of the legend hereunder.

 

    	 	3	 

     

    

 

4.          Securities
Fully Paid; Reservation of Warrant Interests. All of the
Warrant Shares issuable upon the exercise of the Warrant will, upon issuance and receipt of the Warrant Price for such Warrant
Shares, be duly authorized, validly issued, fully paid and non-assessable, and will be free and clear of all taxes, liens, encumbrances
and charges with respect to the issue.

 

5.          Rights
of the Warrant Holder. The Warrant Holder shall have no
voting rights as a member or rights to dividends or other distributions with respect to Warrant Shares subject to this Agreement
until payment in full of the Warrant Price for Warrant Shares being issued and such securities are issued.

 

6.          Adjustment
of Exercise Price and Number of Warrant Shares. The Exercise
Price and the number of Warrant Shares purchasable upon any exercise of the Warrant shall be subject to adjustment from time to
time upon the occurrence of certain events described in this Section 6 if such events occur within the three year period following
the Issue Date.

 

(a)         Subdivision
or Combination of Ownership Shares; Equity Dividend and Interest Conversion.

 

(i)       In
the event the Company should at any time or from time to time fix a record date for the determination of the holders of Ownership
Shares entitled to receive a dividend or other distribution payable in additional Ownership Shares or other securities or rights
directly or indirectly convertible into or exercisable or exchangeable, or rights that entitle the holders of Ownership Shares
to purchase, Ownership Shares (hereinafter referred to as “Ownership Share Equivalents”), without payment of
any consideration by such holders for the additional Ownership Shares or the Ownership Share Equivalents (including the additional
Ownership Shares issuable upon conversion or exercise thereof), then, as of such record date (or the date of such dividend distribution,
split or subdivision if no record date is fixed), (y) the Exercise Price of the Warrant Shares shall be appropriately decreased
or (z) the number of Warrant Shares shall be increased in proportion to such increase of outstanding Ownership Shares and Ownership
Shares issuable with respect to Ownership Share Equivalents.

 

(ii)       If
the number of Ownership Shares outstanding at any time after the Issue Date is decreased by a combination of the outstanding Ownership
Shares, then, upon the record date of such combination, (A) the Exercise Price shall be appropriately increased, or (B) the number
of Warrant Shares shall be decreased in proportion to such decrease in outstanding Ownership Shares.

 

(iii)      The Company will not modify its articles of organization or effect any reorganization, recapitalization, transfer of assets, consolidation,
merger, dissolution, issue or sale of securities in a manner that negates or avoids the rights of the Warrant Holder to exercise
its rights hereunder, but will at all times assist in the carrying out of all the provisions of this Agreement and in the taking
of all such actions as may be necessary or appropriate in order to protect the Warrant Holder against impairment.

 

    	 	4	 

     

    

 

(b)         Other
Notices. In the event that the Company shall propose at any time: (i) to declare any dividend or distribution upon any
class or series of securities, whether in cash, property, stock or other securities (including, without limitation, pursuant to
a subdivision of the outstanding shares of capital stock); (ii) to effect any reclassification or recapitalization of its
Ownership Shares outstanding involving a change in such securities; or (iii) to merge or consolidate with or into any other
corporation, or to sell, lease or convey all or substantially all of its property or business, or to liquidate, dissolve or wind
up; then, in connection with each such event, the Company shall mail to the Warrant Holder notice of such transaction:

 

(A)       at
least five (5) business days’ prior written notice in accordance with Section 10 of the date on which a record shall
be taken for such dividend or distribution (and specifying the date on which the holder of the affected class or series of capital
stock shall be entitled thereto) or for determining the rights to vote, if any, in respect of the matters referred to in (c)(ii)
and (c)(iii) above; and

 

(B)       in
the case of the matters referred to in (c)(ii) and (c)(iii) above, written notice of such impending transaction not later than
ten (10) business days’ prior to any shareholders’ meeting called to approve such transaction, or ten (10) business
days’ prior to the closing of such transaction, whichever is earlier, and shall also notify the Warrant Holder in writing
in accordance with Section 10 of the final approval of such transaction by the stockholders of the Company (if such approval
is required). The first of such notices shall describe the terms and conditions of the impending transaction that are material
to a holder of Ownership Shares (as determined by the Board of Directors of the Company (the “Board”) in good
faith) and specify the date on which a holder of Ownership Shares shall be entitled to exchange his, her or its Ownership Shares
for securities or other property deliverable upon the occurrence of such event) and the Company shall thereafter give such holder
prompt notice of any changes in such terms or conditions that are material to a holder of Ownership Shares (as determined by the
Board in good faith). The Company acknowledges that any record date must be set at a date that would permit the Warrant Holder
effectively to exercise its rights hereunder.

 

(c)       Changes
in Ownership Shares. In case at any time prior to the Expiration Date, the Company shall be a party to any transaction (including,
without limitation, a merger, consolidation, sale of all or substantially all of the Company’s assets or recapitalization
of its capital stock) in which the previously outstanding Ownership Shares shall be changed into or exchanged for different securities
of the Company or other securities of another corporation or interests in a non-corporate entity or other property (including
cash) or the Company shall make a distribution on its Ownership Shares, other than regular cash dividends on its outstanding Ownership
Shares, or any combination of any of the foregoing (each such transaction being herein called the “Transaction”
and the date of consummation of the Transaction being herein called the “Consummation Date”), then as a condition
of the consummation of such Transaction, lawful and adequate provisions shall be made so that the Warrant Holder, upon the exercise
hereof at any time on or after the Consummation Date and prior to the Expiration Date, shall be entitled to receive, and this
Agreement shall thereafter represent the right to receive, in lieu of the Warrant Shares issuable upon such exercise prior to
the Consummation Date, the highest amount of securities or other property to which the Warrant Holder would actually have been
entitled as a member upon the consummation of the Transaction if the Warrant Holder had exercised the Warrant immediately prior
thereto. The provisions of this Section 6(c) shall similarly apply to successive Transactions.

 

    	 	5	 

     

    

 

7.          Taxes.
The Warrant Holder acknowledges that upon exercise of the Warrant the Warrant Holder may be deemed to have taxable income in respect
of the Warrant and/or the Warrant Shares. The Warrant Holder acknowledges that any income or other taxes due from it with respect
to the Warrant or the Warrant Interests issuable pursuant to the Warrant shall be the Warrant Holder’s responsibility.

 

8.          Reserved.

 

9.          Representations
and Warranties.

 

(a)         Representations
and Warranties by the Warrant Holder. The representations and warranties of the Warrant Holder set forth in Section 3 and
4 of the Subscription Agreement are true and correct in all material respects as of the Issue Date.

 

10.        Non-circumvention.
The Company hereby covenants and agrees that the Company will not, by amendment of its articles of organization or operating agreement,
or through any reorganization, transfer of assets, consolidation, merger, scheme of arrangement, dissolution, issue or sale of
securities, or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this Warrant,
and will at all times in good faith carry out all the provisions of this Warrant and take all action as may be required to protect
the rights of the Holder.

 

11.        Reissuance
Of Warrants.

 

(a)         Transfer
of Warrant. If this Warrant is to be transferred, the Warrant Holder shall surrender this Warrant to the Company and an opinion
of counsel from an attorney regularly engaged in the practice of securities law, whereupon the Company will forthwith issue and
deliver upon the order of the Warrant Holder a new Warrant (in accordance with Section 11(d)), registered as the Warrant Holder
may request, representing the right to purchase the number of Warrant Shares being transferred by the Warrant Holder and, if less
than the total number of Warrant Shares then underlying this Warrant is being transferred, a new Warrant (in accordance with Section
11(d)) to the Warrant Holder representing the right to purchase the number of Warrant Shares not being transferred.

 

(b)         Lost,
Stolen or Mutilated Warrant. Upon receipt by the Company of evidence reasonably satisfactory to the Company of the loss, theft,
destruction or mutilation of this Warrant, and, in the case of loss, theft or destruction, of any indemnification and payment
of any required bond undertaking by the Warrant Holder to the Company in customary form and, in the case of mutilation, upon surrender
and cancellation of this Warrant, the Company shall execute and deliver to the Warrant Holder a new Warrant (in accordance with
Section 11(d)) representing the right to purchase the Warrant Shares then underlying this Warrant.

 

(c)         Exchangeable
for Multiple Warrants. This Warrant is exchangeable, upon the surrender hereof by the Warrant Holder at the principal office
of the Company, for a new Warrant or Warrants (in accordance with Section 11(d)) representing in the aggregate the right to purchase
the number of Warrant Shares then underlying this Warrant, and each such new Warrant will represent the right to purchase such
portion of such Warrant Shares as is designated by the Warrant Holder at the time of such surrender.

 

    	 	6	 

     

    

 

(d)         Issuance
of New Warrants. Whenever the Company is required to issue a new Warrant pursuant to the terms of this Warrant, such new Warrant
(i) shall be of like tenor with this Warrant, (ii) shall represent, as indicated on the face of such new Warrant, the right to
purchase the Warrant Shares then underlying this Warrant (or in the case of a new Warrant being issued pursuant to Section 11(a)
or Section 11(c), the Warrant Shares designated by the Warrant Holder which, when added to the number of Conversion Securities
underlying the other new Warrants issued in connection with such issuance, does not exceed the number of Warrant Shares then underlying
this Warrant), (iii) shall have an issuance date, as indicated on the face of such new Warrant which is the same as the Issuance
Date, and (iv) shall have the same rights and conditions as this Warrant.

 

12.        Amendment
And Waiver. Except as otherwise provided herein, the provisions
of this Warrant may be amended and the Company may take any action herein prohibited, or omit to perform any act herein required
to be performed by it, only if the Company has obtained the written consent of the Warrant Holder.

 

13.        Dispute
Resolution.

 

(a)         This
Warrant shall be governed by, and construed in accordance with, the internal laws of the State of Florida without regard to the
choice of law principles thereof. Each of the parties of the Warrant hereto irrevocably submits to the exclusive jurisdiction
of the courts of the State of Florida located in Dade County and the United States District Court for the Southern District of
Florida in Miami for the purpose of any suit, action, proceeding or judgment relating to or arising out of this Warrant. Service
of process in connection with any such suit, action or proceeding may be served on each party hereto anywhere in the world by
the same methods as are specified for the giving of notices under the Subscription Agreement. Each of the parties of this Warrant
irrevocably consents to the jurisdiction of any such court in any such suit, action or proceeding and to the laying of venue in
such court. Each party hereto irrevocably waives any objection to the laying of venue of any such suit, action or proceeding brought
in such courts and irrevocably waives any claim that any such suit, action or proceeding brought in any such court has been brought
in an inconvenient forum. EACH OF THE PARTIES HERETO WAIVES ANY RIGHT TO REQUEST A TRIAL BY JURY IN ANY LITIGATION WITH RESPECT
TO THIS WARRANT AND REPRESENTS THAT COUNSEL HAS BEEN CONSULTED SPECIFICALLY AS TO THIS WAIVER.

 

(b)         Each
party shall bear its own expenses in any litigation conducted under this section.

 

(c)         The
Company consents to accept service of process by the certified mail, return receipt requested in the event of litigation. The
Company further consents to accept service of process via recognized international courier in the case that the Company is not
able to accept service by the certified mail provided a receipt of delivery is available.

 

    	 	7	 

     

    

 

14.        Remedies,
Other Obligations, Breaches And Injunctive Relief. The remedies
provided in this Warrant shall be cumulative and in addition to all other remedies available under this Warrant and the Subscription
Agreement, at law or in equity (including a decree of specific performance and/or other injunctive relief), and nothing herein
shall limit the right of the Warrant Holder to pursue actual damages for any failure by the Company to comply with the terms of
this Warrant. The Company acknowledges that a breach by it of its obligations hereunder will cause irreparable harm to the Warrant
Holder and that the remedy at law for any such breach may be inadequate. The Company therefore agrees that, in the event of any
such breach or threatened breach, the holder of this Warrant shall be entitled, in addition to all other available remedies, to
an injunction restraining any breach, without the necessity of showing economic loss and without any bond or other security being
required. The Company shall provide all information and documentation to the Warrant Holder that is requested by the Holder to
enable the Holder to confirm the Company’s compliance with the terms and conditions of this Warrant (including, without
limitation, compliance with Section 6 hereof).

 

15.       Transfer.This
Warrant may be offered for sale, sold, transferred or assigned without the consent of the Company.

 

16.        Severability.
If any provision of this Warrant is prohibited by law or otherwise determined to be invalid or unenforceable by a court of competent
jurisdiction, the provision that would otherwise be prohibited, invalid or unenforceable shall be deemed amended to apply to the
broadest extent that it would be valid and enforceable, and the invalidity or unenforceability of such provision shall not affect
the validity of the remaining provisions of this Warrant so long as this Warrant as so modified continues to express, without
material change, the original intentions of the parties as to the subject matter hereof and the prohibited nature, invalidity
or unenforceability of the provision(s) in question does not substantially impair the respective expectations or reciprocal obligations
of the parties or the practical realization of the benefits that would otherwise be conferred upon the parties. The parties will
endeavor in good faith negotiations to replace the prohibited, invalid or unenforceable provision(s) with a valid provision(s),
the effect of which comes as close as possible to that of the prohibited, invalid or unenforceable provision(s).

 

17.        Assignability.
Notwithstanding anything contained herein to the contrary, subject to the transfer and securities law restrictions set forth in
this Agreement, the Warrant Holder may assign, convey or transfer, in whole or in part, its rights under this Agreement and provide
written notice to Company of any such assignment, conveyance or transfer. Upon any transfer, assignment, pledge, hypothecation
or other disposition of the Warrant or of any rights granted hereunder in accordance with the terms of this Section 17,
the Company shall if necessary issue or re-issue warrant agreements reflecting the appropriate rights and entitlements of the
Warrant Holder and any transferee, assignee or pledgee after giving effect to such transfer, assignment or pledge.

 

18.        Notice.
Any notice to be provided hereunder, unless otherwise herein specified, shall be provided in the manner set forth in Exhibit A
signature page of the Subscription Agreement.

 

[signatures
on following page]

 

    	 	8	 

     

    

 

IN
WITNESS WHEREOF, the undersigned hereby execute this Agreement as of the day and year first above written.

 

	 	COMPANY:
	 	 
	 	HEALTHLYNKED
    CORPORATION
	 	 	 
	 	By:	 
	 	Name:	George
    O'Leary
	 	Title:	CFO
	 	 	 
	 	WARRANT
    HOLDER:
	 	 	 
	 	By:	 
	 	Name:	Michael
    Dent

 

[Signature
Page – Warrant Agreement]

 

     

     

    

 

EXHIBIT
A

 

NOTICE
OF EXERCISE

 

The
undersigned holder hereby exercises the right to purchase _________________ shares of ______________ (“Warrant Shares”)
of HealthLynked Corporation, a Nevada Corporation (the “Company”), evidenced by the attached Warrant No. __
(the “Warrant”). Capitalized terms used herein and not otherwise defined shall have the respective meanings
set forth in the Warrant.

 

1.
Form of Exercise Price. The Warrant Holder intends that payment of the Exercise Price shall be made as:

 

____________       a
“Cash Exercise” with respect to _________________ Warrant Shares.

 

2.
Payment of Exercise Price. The holder shall pay the Aggregate Exercise Price in the sum of $___________ to the Company in accordance
with the terms of the Warrant.

 

3.
Delivery of Warrant Shares. The Company shall deliver to the holder __________ Warrant Shares in accordance with the terms of
the Warrant.

 

Date:
_______________ __, ______

 

_________________________

Name
of Registered Holder

  

	By:	 	 
	 	Name:	 
	 	Title:Wolverine Technologies Corp.: Exhibit 10.1 - Filed by newsfilecorp.com

THIS PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT (THE
"SUBSCRIPTION AGREEMENT") RELATES TO AN OFFERING OF SECURITIES IN AN OFFSHORE
TRANSACTION TO PERSONS WHO ARE NOT U.S. PERSONS (AS DEFINED HEREIN) PURSUANT TO
REGULATION S UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE
"1933 ACT").

NONE OF THE SECURITIES TO WHICH THIS SUBSCRIPTION AGREEMENT
RELATES HAVE BEEN REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES
LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED OR SOLD, DIRECTLY OR
INDIRECTLY, IN THE UNITED STATES OR TO U.S. PERSONS (AS DEFINED HEREIN) EXCEPT
IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT
TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN
AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION
REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE
STATE SECURITIES LAWS.

PRIVATE PLACEMENT SUBSCRIPTION 
FOR NON U.S. SUBSCRIBERS

 

PRIVATE PLACEMENT 

INSTRUCTIONS TO SUBSCRIBER: 

	1. 	
      COMPLETE the information on page 2 of this
      Subscription Agreement.

	 	 
	2. 	
      IF RESIDENT IN CANADA COMPLETE the Questionnaire
      attached as Schedule A to this Subscription Agreement (the
      "Questionnaire").

	 	 
	3. 	
      COURIER a certified cheque or bank draft in CDN
      Funds payable to Wolverine Technologies Corp. to #55-11020 Williams Road,
      Richmond, BC, V7A 1X8.

	 	 
	4. 	
      FAX a copy of page 2 of this Subscription
      Agreement, and all pages of the Questionnaire to PubCo Services Inc. at
      (403) 275-4462 or by e-mail to
pubco@telus.net.

2

WOLVERINE TECHNOLOGIES CORP. 
PRIVATE PLACEMENT 

The Subscriber hereby irrevocably subscribes for, and on
Closing will purchase from the Company, the following securities at a price of
CDN$0.005 per Share 

	________________________ Shares

The Subscriber directs the Company to issue, register and
deliver the certificates representing the Shares as follows: 

	 	REGISTRATION INSTRUCTIONS: 	 	DELIVERY INSTRUCTIONS: 	 
	 	 	 	 	 
	 	 	 	 	 
	 	Name to appear on certificate 	 	Name and account reference, if applicable 	 
	 	 	 	 	 
	 	 	 	 	 
	 	SIN/Tax ID No. 	 	Contact name 	 
	 	 	 	 	 
	 	 	 	 	 
	 	Address 	 	Address 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 
    	 	Telephone number 	 

	
      EXECUTED by the Subscriber this day of
      __________ , _____ . By executing this Agreement, the Subscriber certifies
      that the Subscriber and any beneficial purchaser for whom the
      Subscriber is acting is resident in the jurisdiction shown as the “Address
      of the Subscriber”. The address of the Subscriber will be accepted
      by the Company as a representative as to the address of residency for
      the Subscriber. 

	 	WITNESS: 	 	EXECUTION BY SUBSCRIBER: 	 
	 	 	 	 	 
	 	 	 	X 	 
	 	Signature of witness 	 	Signature of individual (if Subscriber is
      an individual) 	 
	 	 	 	 	 
	 	 	 	X 	 
	 	Name of witness 	 	Authorized signatory (if Subscriber is not
      an individual) 	 
	 	 	 	  	 
	 	 	 	 	 
	 	Address of witness 	 	Name of Subscriber (please print) 	 
	 	 	 	  	 
	 	 	 	 	 
	 	 	 	Name of authorized signatory (please
      print) 	 
	 	ACCEPTED this day of ___________, _____.
    	 	  	 
	 	 	 	 	 
	 	WOLVERINE TECHNOLOGIES CORP. 	 	Address of Subscriber (residence) 	 
	 	Per: 	 	  	 
	 	 	 	 	 
	 	Authorized signatory 	 	Telephone number and e-mail address 	 

By signing this acceptance, the Company agrees to be bound by
all representations, warranties, covenants and agreements on pages 3-11 hereof.

This Subscription Agreement may be executed in any number of
counterparts, each of which, when so executed and delivered, shall constitute an
original and all of which together shall constitute one instrument. Delivery of
an executed copy of this Subscription Agreement by electronic facsimile
transmission or other means of electronic communication capable of producing a
printed copy will be deemed to be execution and delivery of this Subscription
Agreement as of the date hereinafter set forth. 

3

THIS PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT (THE
"SUBSCRIPTION AGREEMENT") RELATES TO AN OFFERING OF SECURITIES IN AN OFFSHORE
TRANSACTION TO PERSONS WHO ARE NOT U.S. PERSONS (AS DEFINED HEREIN) PURSUANT TO
REGULATION S UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE
"1933 ACT").

NONE OF THE SECURITIES TO WHICH THIS SUBSCRIPTION AGREEMENT
RELATES HAVE BEEN REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES
LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED OR SOLD, DIRECTLY OR
INDIRECTLY, IN THE UNITED STATES OR TO U.S. PERSONS (AS DEFINED HEREIN) EXCEPT
IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT
TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN
AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION
REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE
STATE SECURITIES LAWS.

PRIVATE PLACEMENT SUBSCRIPTION 
(Non U.S. Subscribers
Only) 

	TO: 	Wolverine Technologies Corp. (the “Company”)
  
	  	#55-11020 Williams Road, Richmond, 
	  	British Columbia, Canada V7A 1X8

Purchase of Shares 

1. SUBSCRIPTION 

1.1 The undersigned (the "Subscriber") hereby irrevocably
subscribes for and agrees to purchase the number of shares of the Company's
common stock (the "Shares") as set out on page 2 of this Subscription Agreement
at a price of CDN$0.005 per Share (such subscription and agreement to purchase
being the "Subscription"), for the total subscription price as set out on page 2
of this Subscription Agreement (the "Subscription Proceeds"), which Subscription
Proceeds are tendered herewith, on the basis of the representations and
warranties and subject to the terms and conditions set forth herein. The Shares
are referred to as the “Securities”. 

1.2 The Company hereby agrees to sell, on the basis of the
representations and warranties and subject to the terms and conditions set forth
herein, to the Subscriber the Shares. Subject to the terms hereof, the
Subscription Agreement will be effective upon its acceptance by the Company.

1.3 Unless otherwise provided, all dollar amounts referred to
in this Subscription Agreement are in lawful money of the United States of
America. 

2. PAYMENT 

2.1 The Subscription Proceeds must accompany this Subscription
Agreement. The Subscriber authorizes the Company's lawyers to deliver the
Subscription Proceeds to the Company if the Subscription Proceeds are delivered
to the Company’s lawyers, without further instructions required. 

2.2 The Subscriber acknowledges and agrees that this
Subscription Agreement and any other documents delivered in connection herewith
will be held by the Company's lawyers on behalf of the Company. In the event
that this Subscription Agreement is not accepted by the Company for whatever
reason within 90 days of the delivery of an executed Subscription Agreement by
the Subscriber, or the minimum offering amount is not achieved by that time,
this Subscription Agreement, the Subscription Proceeds and any other documents
delivered in connection herewith will be returned to the Subscriber at the
address of the Subscriber as set forth in this Subscription Agreement without
interest or deduction. 

4

2.3 Where the Subscription Proceeds are paid to the Company,
the Company may treat the Subscription Proceeds as a non-interest bearing loan
and may use the Subscription Proceeds prior to this Subscription Agreement being
accepted by the Company. 

2.4 If resident in Canada, the Subscriber must complete, sign
and return to the Company an executed copy of this Subscription Agreement, the
Questionnaire attached hereto as Schedule A (the “Questionnaire”) and any other
schedules attached hereto. 

2.5 The Subscriber shall complete, sign and return to the
Company as soon as possible, on request by the Company, any documents,
questionnaires, notices and undertakings as may be required by regulatory
authorities, stock exchanges and applicable law. 

3. CLOSING 

3.1 Closing of the purchase and sale of the Shares shall occur
on or before _____________, 2018, or on such other date as may be determined by
the Company in its sole discretion (the "Closing Date"). The Subscriber
acknowledges that Shares may be issued to other subscribers under this offering
(the "Offering") before or after the Closing Date. The Company, may, at its
discretion, elect to close the Offering in one or more closings, in which event
the Company may agree with one or more subscribers (including the Subscriber
hereunder) to complete delivery of the Shares to such subscriber(s) against
payment therefore at any time on or prior to the Closing Date. 

4. ACKNOWLEDGEMENTS OF SUBSCRIBER

4.1 The Subscriber acknowledges and agrees that: 

	 	(a) 	
      none of the Securities have been registered under the
      Securities Act of 1933, as amended (the "1933 Act"), or under any state
      securities or "blue sky" laws of any state of the United States, and are
      being offered only in a transaction not involving any public offering
      within the meaning of the 1933 Act, and, unless so registered, may not be
      offered or sold in the United States or to U.S. Persons (as defined
      herein), except pursuant to an effective registration statement under the
      1933 Act, or pursuant to an exemption from, or in a transaction not
      subject to, the registration requirements of the 1933 Act, and in each
      case only in accordance with applicable state and provincial securities
      laws;

	 	 	 
	 	(b) 	
      the Company will refuse to register any transfer of any
      of the Securities not made in accordance with the provisions of Regulation
      S, pursuant to an effective registration statement under the 1933 Act or
      pursuant to an available exemption from, or in a transaction not subject
      to, the registration requirements of the 1933 Act;

	 	 	 
	 	(c) 	
      by completing the Questionnaire, the Subscriber is
      representing and warranting that the Subscriber satisfies one of the
      categories of registration and prospectus exemptions provided for in
      National Instrument 45-106 ("NI 45-106") adopted by the Canadian
      Securities Administrators (the "CSA");

	 	 	 
	 	(d) 	
      the decision to execute this Subscription Agreement and
      purchase the Shares agreed to be purchased hereunder has not been based
      upon any oral or written representation as to fact or otherwise made by or
      on behalf of the Company and such decision is based solely upon a review
      of publicly available information regarding the Company available on the
      website of the United States Securities and Exchange Commission (the
      "SEC") available at www.sec.gov (the "Company Information");

	 	 	 
	 	(e) 	
      the Subscriber and the Subscriber's advisor(s) have had a
      reasonable opportunity to review the Company Information and to ask
      questions of and receive answers from the Company
  regarding the Offering, and to obtain additional information, to
      the extent possessed or obtainable without unreasonable effort or expense,
      necessary to verify the accuracy of the information contained in the
      Company Information, or any other document provided to the
  Subscriber;

5

	 	(f) 	
      the books and records of the Company were available upon
      reasonable notice for inspection, subject to certain confidentiality
      restrictions, by the Subscriber during reasonable business hours at its
      principal place of business and that all documents, records and books
      pertaining to this Offering have been made available for inspection by the
      Subscriber, the Subscriber's attorney and/or advisor(s);

	 	 	 	 
	 	(g) 	
      by execution hereof the Subscriber has waived the need
      for the Company to communicate its acceptance of the purchase of the
      Shares pursuant to this Subscription Agreement;

	 	 	 	 
	 	(h) 	
      the Company is entitled to rely on the representations
      and warranties and the statements and answers of the Subscriber contained
      in this Subscription Agreement and the Questionnaire and the Subscriber
      will hold harmless the Company from any loss or damage it may suffer as a
      result of the Subscriber's failure to correctly complete this Subscription
      Agreement and the Questionnaire;

	 	 	 	 
	 	(i) 	
      the Subscriber will indemnify and hold harmless the
      Company and, where applicable, its respective directors, officers,
      employees, agents, advisors and shareholders from and against any and all
      loss, liability, claim, damage and expense whatsoever (including, but not
      limited to, any and all fees, costs and expenses whatsoever reasonably
      incurred in investigating, preparing or defending against any claim,
      lawsuit, administrative proceeding or investigation whether commenced or
      threatened) arising out of or based upon any acknowledgment,
      representation or warranty of the Subscriber contained herein, the
      Questionnaire or in any other document furnished by the Subscriber to the
      Company in connection herewith, being untrue in any material respect or
      any breach or failure by the Subscriber to comply with any covenant or
      agreement made by the Subscriber to the Company in connection
      therewith;

	 	 	 	 
	 	(j) 	
      the issuance and sale of the Shares to the Subscriber
      will not be completed if it would be unlawful or if, in the discretion of
      the Company acting reasonably, it is not in the best interests of the
      Company;

	 	 	 	 
	 	(k) 	
      the Subscriber has been advised to consult the
      Subscriber’s own legal, tax and other advisors with respect to the merits
      and risks of an investment in the Securities and with respect to the
      applicable resale restrictions, and it is solely responsible (and the
      Company is not in any way responsible) for compliance with:

	 	 	 	 
	 		(i) 	
      any applicable laws of the jurisdiction in which the
      Subscriber is resident in connection with the distribution of the
      Securities hereunder, and

	 	 	 	 
	 		(ii) 	
      applicable resale restrictions;

	 	 	 	 
	 	(l) 	
      the Subscriber has not acquired the Shares as a result
      of, and will not itself engage in, any "directed selling efforts" (as
      defined in Regulation S under the 1933 Act) in the United States in
      respect of any of the Securities which would include any activities
      undertaken for the purpose of, or that could reasonably be expected to
      have the effect of, conditioning the market in the United States for the
      resale of any of the Securities; provided, however, that the Subscriber
      may sell or otherwise dispose of any of the Shares pursuant to
      registration of any of the Shares pursuant to the 1933 Act and any
      applicable state securities laws or under an exemption from such
      registration requirements and as otherwise provided herein;

	 	 	 	 
	 	(m) 	
      the Subscriber is outside the United States when
      receiving and executing this Subscription Agreement and is acquiring the
      Shares as principal for its own account, for investment
  purposes only, and not with a view to, or for, resale,
      distribution or fractionalization thereof, in whole or in part, and no
      other person has a direct or indirect beneficial interest in such
  Shares;

6

	 	(n) 	
      the statutory and regulatory basis for the exemption
      claimed for the offer and sale of the Shares, although in technical
      compliance with Regulation S, would not be available if the offering is
      part of a plan or scheme to evade the registration provisions of the 1933
      Act;

	 	 	 
	 	(o) 	
      the Company has advised the Subscriber that, if the
      Subscriber is a Canadian resident, the Company is relying on an exemption
      from the requirements to provide the Subscriber with a prospectus and to
      sell the Shares through a person registered to sell securities and, as a
      consequence of acquiring the Shares pursuant to this exemption, certain
      protections, rights and remedies provided, including statutory rights of
      rescission or damages, will not be available to the Subscriber;

	 	 	 
	 	(p) 	
      neither the SEC nor any other securities commission or
      similar regulatory authority has reviewed or passed on the merits of any
      of the Securities;

	 	 	 
	 	(q) 	
      no documents in connection with this Offering have been
      reviewed by the SEC or any state securities administrators;

	 	 	 
	 	(r) 	
      there is no government or other insurance covering any of
      the Securities; and

	 	 	 
	 	(s) 	
      this Subscription Agreement is not enforceable by the
      Subscriber unless it has been accepted by the Company, and the Subscriber
      acknowledges and agrees that the Company reserves the right to reject any
      subscription for any reason.

5. REPRESENTATIONS, WARRANTIES AND
COVENANTS OF THE SUBSCRIBER 

5.1 The Subscriber hereby represents and warrants to and
covenants with the Company (which representations, warranties and covenants
shall survive the Closing Date) that: 

	 	(a) 	
      the Subscriber is not a U.S. Person (as defined
      herein);

	 	 	 	 
		(b) 	
      the Subscriber is not acquiring the Shares for the
      account or benefit of, directly or indirectly, any U. S. Person (as
      defined herein);

	 	 	 	 
	 	(c) 	
      the Subscriber is resident in the jurisdiction set out on
      page 2 of this Subscription Agreement;

	 	 	 	 
	 	(d) 	
      the Subscriber:

	 	 	 	 
			
      (i) 
	is knowledgeable of, or has been independently advised
      as to, the applicable securities laws of the securities regulators having
      application in the jurisdiction in which the Subscriber is resident (the
      “International Jurisdiction”) which would apply to the acquisition of the
      Shares,
	 	 	 	 
			
      (ii) 
	is purchasing the Shares pursuant to exemptions from
      prospectus or equivalent requirements under applicable securities laws or,
      if such is not applicable, the Subscriber is permitted to purchase the
      Shares under the applicable securities laws of the securities regulators
      in the International Jurisdiction without the need to rely on any
      exemptions,
	 	 	 	 
			
      (iii) 
	acknowledges that the applicable securities laws of the
      authorities in the International Jurisdiction do not require the Company
      to make any filings or seek any approvals of any kind whatsoever from any
      securities regulator of any kind whatsoever in the International
      Jurisdiction in connection with the issue and sale or resale of any of the
      Securities, and

7

	 	(iv) 	
      represents and warrants that the acquisition of the
      Shares by the Subscriber does not trigger:

	 	 	 	 
	 		A. 	
      any obligation to prepare and file a prospectus or
      similar document, or any other report with respect to such purchase in the
      International Jurisdiction, or

	 	 	 	 
	 		B. 	
      any continuous disclosure reporting obligation of the
      Company in the International Jurisdiction, and

	 	 	 	 
	 		
      the Subscriber will, if requested by the Company, deliver
      to the Company a certificate or opinion of local counsel from the
      International Jurisdiction which will confirm the matters referred to in
      subparagraphs (ii), (iii) and (iv) above to the satisfaction of the
      Company, acting reasonably;

	 	(e) 	
      the Subscriber is acquiring the Shares as principal for
      investment only and not with a view to, or for, resale, distribution or
      fractionalization thereof, in whole or in part, and, in particular, it has
      no intention to distribute either directly or indirectly any of the
      Securities in the United States or to U.S. Persons (as defined
    herein);

	 	 	 
	 	(f) 	
      the Subscriber is outside the United States when
      receiving and executing this Subscription Agreement;

	 	 	 
	 	(g) 	
      the Subscriber understands and agrees not to engage in
      any hedging transactions involving any of the Securities unless such
      transactions are in compliance with the provisions of the 1933 Act and in
      each case only in accordance with applicable state securities
  laws;

	 	 	 
	 	(h) 	
      the Subscriber acknowledges that it has not acquired the
      Shares as a result of, and will not itself engage in, any "directed
      selling efforts" (as defined in Regulation S under the 1933 Act) in the
      United States in respect of any of the Securities which would include any
      activities undertaken for the purpose of, or that could reasonably be
      expected to have the effect of, conditioning the market in the United
      States for the resale of any of the Securities; provided, however, that
      the Subscriber may sell or otherwise dispose of any of the Shares pursuant
      to registration of any of the Shares pursuant to the 1933 Act and any
      applicable state securities laws or under an exemption from such
      registration requirements and as otherwise provided herein;

	 	 	 
	 	(i) 	
      the Subscriber has the legal capacity and competence to
      enter into and execute this Subscription Agreement and to take all actions
      required pursuant hereto and, if the Subscriber is a corporation, it is
      duly incorporated and validly subsisting under the laws of its
      jurisdiction of incorporation and all necessary approvals by its
      directors, shareholders and others have been obtained to authorize
      execution and performance of this Subscription Agreement on behalf of the
      Subscriber;

	 	 	 
	 	(j) 	
      the entering into of this Subscription Agreement and the
      transactions contemplated hereby do not result in the violation of any of
      the terms and provisions of any law applicable to, or, if applicable, the
      constating documents of, the Subscriber, or of any agreement, written or
      oral, to which the Subscriber may be a party or by which the Subscriber is
      or may be bound;

	 	 	 
	 	(k) 	
      the Subscriber has duly executed and delivered this
      Subscription Agreement and it constitutes a valid and binding agreement of
      the Subscriber enforceable against the Subscriber;

	 	 	 
	 	(l) 	
      the Subscriber has received and carefully read this
      Subscription Agreement;

	 	 	 
	 	(m) 	
      the Subscriber (i) has adequate net worth and means of
      providing for its current financial needs and possible personal
      contingencies, (ii) has no need for liquidity in this investment, and
      (iii) is able to bear the economic risks of an investment in the
      Securities for an indefinite period of time, and can afford the complete
      loss of such investment;

8

	 	(n) 	
      the Subscriber has the requisite knowledge and experience
      in financial and business matters as to be capable of evaluating the
      merits and risks of the investment in the Securities and the Company, and
      the Subscriber is providing evidence of knowledge and experience in these
      matters through the information requested in the Questionnaire;

	 	 	 	 
	 	(o) 	
      the Subscriber understands and agrees that the Company
      and others will rely upon the truth and accuracy of the acknowledgements,
      representations, warranties, covenants and agreements contained in this
      Subscription Agreement and the Questionnaire, and agrees that if any of
      such acknowledgements, representations and agreements are no longer
      accurate or have been breached, the Subscriber shall promptly notify the
      Company;

	 	 	 	 
	 	(p) 	
      the Subscriber is aware that an investment in the Company
      is speculative and involves certain risks, including the possible loss of
      the investment;

	 	 	 	 
	 	(q) 	
      the Subscriber is purchasing the Shares for its own
      account for investment purposes only and not for the account of any other
      person and not for distribution, assignment or resale to others, and no
      other person has a direct or indirect beneficial interest is such Shares,
      and the Subscriber has not subdivided his interest in the Shares with any
      other person;

	 	 	 	 
	 	(r) 	
      the Subscriber is not an underwriter of, or dealer in,
      the shares of the Company's common stock, nor is the Subscriber
      participating, pursuant to a contractual agreement or otherwise, in the
      distribution of the Shares;

	 	 	 	 
	 	(s) 	
      the Subscriber has made an independent examination and
      investigation of an investment in the Securities and the Company and has
      depended on the advice of its legal and financial advisors and agrees that
      the Company will not be responsible in anyway whatsoever for the
      Subscriber's decision to invest in the Securities and the
  Company;

	 	 	 	 
	 	(t) 	
      if the Subscriber is acquiring the Shares as a fiduciary
      or agent for one or more investor accounts, the Subscriber has sole
      investment discretion with respect to each such account, and the
      Subscriber has full power to make the foregoing acknowledgements,
      representations and agreements on behalf of such account;

	 	 	 	 
	 	(u) 	
      the Subscriber is not aware of any advertisement of any
      of the Shares and is not acquiring the Shares as a result of any form of
      general solicitation or general advertising including advertisements,
      articles, notices or other communications published in any newspaper,
      magazine or similar media or broadcast over radio or television, or any
      seminar or meeting whose attendees have been invited by general
      solicitation or general advertising;

	 	 	 	 
	 	(v) 	
      no person has made to the Subscriber any written or oral
      representations:

	 	 	 	 
	 		(i) 	
      that any person will resell or repurchase any of the
      Securities,

	 	 	 	 
	 		(ii) 	
      that any person will refund the purchase price of any of
      the Securities,

	 	 	 	 
	 		(iii) 	
      as to the future price or value of any of the Securities,
      or

	 	 	 	 
	 		(iv) 	
      that any of the Securities will be listed and posted for
      trading on any stock exchange or automated dealer quotation system or that
      application has been made to list and post any of the Securities of the
      Company on any stock exchange or automated dealer quotation system;
    and

	 	 	 	 
	 	(w) 	
      the Subscriber acknowledges and agrees that the Company
      shall not consider the Subscriber's Subscription for acceptance unless the
      undersigned provides to the Company, along with an executed copy of this
      Subscription Agreement:

9

	 	(i) 	
      a fully completed and executed Questionnaire in the form
      attached hereto as Schedule A, and

	 	 	 
	 	(ii) 	
      such other supporting documentation that the Company or
      its legal counsel may request to establish the Subscriber's qualification
      as a qualified investor.

5.2 In this Subscription Agreement, the term "U.S. Person"
shall have the meaning ascribed thereto in Regulation S promulgated under the
1933 Act and for the purpose of the Subscription Agreement includes any person
in the United States. 

6. ACKNOWLEDGEMENT AND WAIVER

6.1 The Subscriber has acknowledged that the decision to
purchase the Shares was solely made on the Company Information. The Subscriber
hereby waives, to the fullest extent permitted by law, any rights of withdrawal,
rescission or compensation for damages to which the Subscriber might be entitled
in connection with the distribution of any of the Shares. 

7. REPRESENTATIONS AND WARRANTIES WILL BE
RELIED UPON BY THE COMPANY 

7.1 The Subscriber acknowledges that the acknowledgements,
representations and warranties contained herein and in the Questionnaire are
made by it with the intention that they may be relied upon by the Company and
its legal counsel in determining the Subscriber's eligibility to purchase the
Shares under applicable securities legislation, or (if applicable) the
eligibility of others on whose behalf it is contracting hereunder to purchase
the Shares under applicable securities legislation. The Subscriber further
agrees that by accepting delivery of the certificates representing the Shares,
it will be representing and warranting that the acknowledgements representations
and warranties contained herein and in the Questionnaire are true and correct as
of the date hereof and will continue in full force and effect notwithstanding
any subsequent disposition by the Subscriber of such Shares. 

8. RESALE RESTRICTIONS 

8.1 The Subscriber acknowledges that any resale of the
Securities will be subject to resale restrictions contained in the securities
legislation applicable to the Subscriber or proposed transferee. The Subscriber
acknowledges that none of the Securities have been registered under the 1933 Act
or the securities laws of any state of the United States. None of the Securities
may be offered or sold in the United States unless registered in accordance with
federal securities laws and all applicable state securities laws or exemptions
from such registration requirements are available. 

9. LEGENDING AND REGISTRATION OF SUBJECT
SECURITIES 

9.1 The Subscriber hereby acknowledges that upon the issuance
thereof, and until such time as the same is no longer required under the
applicable securities laws and regulations, the certificates representing the
Shares will bear a legend in substantially the following form: 

	
      THE SECURITIES REPRESENTED HEREBY HAVE BEEN OFFERED IN AN
      OFFSHORE TRANSACTION TO A PERSON WHO IS NOT A U.S. PERSON (AS DEFINED
      HEREIN) PURSUANT TO REGULATION S UNDER THE UNITED STATES SECURITIES ACT OF
      1933, AS AMENDED (THE "1933 ACT"). 

	
       

	
      NONE OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN
      REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES LAWS, AND,
      UNLESS SO REGISTERED, MAY NOT BE OFFERED OR SOLD, DIRECTLY OR INDIRECTLY,
      IN THE UNITED STATES (AS DEFINED HEREIN) OR TO U.S. PERSONS EXCEPT IN ACCORDANCE
      WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN
      EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN
      AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE
      REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN
      ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. IN ADDITION, HEDGING
      TRANSACTIONS INVOLVING THE SECURITIES MAY NOT BE CONDUCTED UNLESS IN
      COMPLIANCE WITH THE 1933 ACT. "UNITED STATES" AND "U.S. PERSON" ARE AS
    DEFINED BY REGULATION S UNDER THE 1933 ACT. 

10

9.2 The Subscriber hereby acknowledges and agrees to the
Company making a notation on its records or giving instructions to the registrar
and transfer agent of the Company in order to implement the restrictions on
transfer set forth and described in this Subscription Agreement. 

10. COLLECTION OF PERSONAL
INFORMATION 

10.1 The Subscriber acknowledges and consents to the fact that
the Company is collecting the Subscriber's personal information for the purpose
of fulfilling this Subscription Agreement and completing the Offering. The
Subscriber's personal information (and, if applicable, the personal information
of those on whose behalf the Subscriber is contracting hereunder) may be
disclosed by the Company to (a) stock exchanges or securities regulatory
authorities, (b) the Company's registrar and transfer agent, (c) Canadian tax
authorities, (d) authorities pursuant to the Proceeds of Crime (Money
Laundering) and Terrorist Financing Act (Canada) and (e) any of the other
parties involved in the Offering, including legal counsel, and may be included
in record books in connection with the Offering. By executing this Subscription
Agreement, the Subscriber is deemed to be consenting to the foregoing
collection, use and disclosure of the Subscriber's personal information (and, if
applicable, the personal information of those on whose behalf the Subscriber is
contracting hereunder) and to the retention of such personal information for as
long as permitted or required by law or business practice. Notwithstanding that
the Subscriber may be purchasing Shares as agent on behalf of an undisclosed
principal, the Subscriber agrees to provide, on request, particulars as to the
identity of such undisclosed principal as may be required by the Company in
order to comply with the foregoing. 

11. COSTS 

11.1 The Subscriber acknowledges and agrees that all costs and
expenses incurred by the Subscriber (including any fees and disbursements of any
special counsel retained by the Subscriber) relating to the purchase of the
Shares shall be borne by the Subscriber. 

12. GOVERNING LAW 

12.1 This Subscription Agreement is governed by the laws of the
State of Nevada. The Subscriber, in its personal or corporate capacity and, if
applicable, on behalf of each beneficial purchaser for whom it is acting,
irrevocably attorns to the exclusive jurisdiction of the Courts of the State of
Nevada. 

13. SURVIVAL 

13.1 This Subscription Agreement, including without limitation
the representations, warranties and covenants contained herein, shall survive
and continue in full force and effect and be binding upon the parties hereto
notwithstanding the completion of the purchase of the Shares by the Subscriber
pursuant hereto. 

14. ASSIGNMENT 

14.1 This Subscription Agreement is not transferable or
assignable. 

11

15. SEVERABILITY 

15.1 The invalidity or unenforceability of any particular
provision of this Subscription Agreement shall not affect or limit the validity
or enforceability of the remaining provisions of this Subscription Agreement.

16. ENTIRE AGREEMENT 

16.1 Except as expressly provided in this Subscription
Agreement and in the agreements, instruments and other documents contemplated or
provided for herein, this Subscription Agreement contains the entire agreement
between the parties with respect to the sale of the Shares and there are no
other terms, conditions, representations or warranties, whether expressed,
implied, oral or written, by statute or common law, by the Company or by anyone
else. 

17. NOTICES 

17.1 All notices and other communications hereunder shall be in
writing and shall be deemed to have been duly given if mailed or transmitted by
any standard form of telecommunication. Notices to the Subscriber shall be
directed to the address on page 2 and notices to the Company shall be directed
to it at the first page of this Subscription Agreement. 

18. COUNTERPARTS AND ELECTRONIC
MEANS 

18.1 This Subscription Agreement may be executed in any number
of counterparts, each of which, when so executed and delivered, shall constitute
an original and all of which together shall constitute one instrument. Delivery
of an executed copy of this Subscription Agreement by electronic facsimile
transmission or other means of electronic communication capable of producing a
printed copy will be deemed to be execution and delivery of this Subscription
Agreement as of the date hereinafter set forth. 

SCHEDULE A 

CANADIAN QUESTIONNAIRE 

All capitalized terms herein, unless otherwise defined, have
the meanings ascribed thereto in the Subscription Agreement. 

The purpose of this Questionnaire is to assure the Company that
the Subscriber will meet certain requirements of National Instrument 45-106 ("NI
45-106"). The Company will rely on the information contained in this
Questionnaire for the purposes of such determination. 

The Subscriber covenants, represents and warrants to the
Company that: 

	 	1. 	
      the Subscriber has such knowledge and experience in
      financial and business matters as to be capable of evaluating the merits
      and risks of the transactions detailed in the Subscription Agreement and
      the Subscriber is able to bear the economic risk of loss arising from such
      transactions;

	 	 	 
	 	2. 	
      the Subscriber is (tick one or more of the following
      boxes):

	 	(A) 	
      a director, executive officer, employee or control person
      of the Company or an affiliate of the Company
	[   ]
	 	 	 	 
	 	(B) 	
      a spouse, parent, grandparent, brother, sister or child
      of a director, executive officer, founder or control person of the Company
      or an affiliate of the Company
	[   ]
	 	 	 	 
	 	(C) 	
      a parent, grandparent, brother, sister or child of the
      spouse of a director, executive officer, founder or control person of the
      Company or an affiliate of the Company
	[   ]
	 	 	 	 
	 	(D) 	
      a close personal friend of a director, executive officer,
      founder or control person of the Company
	[   ]
	 	 	 	 
	 	(E) 	
      a close business associate of a director, executive
      officer, founder or control person of the Company or an affiliate of the
      Company
	[   ]
	 	 	 	 
	 	(F) 	
      an accredited investor
	[   ]
	 	 	 	 
	 	(G) 	
      a company, partnership or other entity of which a
      majority of the voting securities are beneficially owned by, or a majority
      of the directors are, persons described in paragraphs A to F
	[   ]
	 	 	 	 
	 	(H) 	
      a trust or estate of which all of the beneficiaries or a
      majority of the trustees or executors are persons described in paragraphs
      A to F
	[   ]
	 	 	 	 
	 	(I) 	
      purchasing as principal Securities with an aggregate
      acquisition cost of not less than CDN$150,000
	 [    
]

- 2 - 

	3. 	
      if the Subscriber has checked box B, C, D, E, G or H in
      Section 2 above, the director, executive officer, founder or control
      person of the Company with whom the undersigned has the relationship
      is:

	 	 
		
       

	 	 
		
      (Instructions to Subscriber: fill in the name of each
      director, executive officer, founder and control person which you have the
      above-mentioned relationship with. If you have checked box G or H, also
      indicate which of A to F describes the securityholders, directors,
      trustees or beneficiaries which qualify you as box G or H and provide the
      names of those individuals. Please attach a separate page if
      necessary).

	 	 
	4. 	
      if the Subscriber is resident in Ontario, the Subscriber
      is (tick one or more of the following
boxes):

	 	(A) 	
      a founder of the Company
	[   ]
	 	 	 	 
	 	(B) 	
      an affiliate of a founder of the Company
	[   ]
	 	 	 	 
	 	(C) 	
      a spouse, parent, brother, sister, grandparent or child
      of a director, executive officer or founder of the Company
	[   ]
	 	 	 	 
	 	(D) 	
      a person that is a control person of the Company
	[   ]
	 	 	 	 
	 	(E) 	
      an accredited investor
	[   ]
	 	 	 	 
	 	(F) 	
      purchasing as principal Securities with an aggregate
      acquisition cost of not less than CDN$150,000
	[   ]

	5. 	
      if the Subscriber has checked box A, B, C or D in Section
      4 above, the director, executive officer, founder or control person of the
      Company with whom the undersigned has the relationship is:

	 	 
		
       

	 	 
		
      (Instructions to Subscriber: fill in the name of each
      director, executive officer, founder, affiliate and control person which
      you have the above-mentioned relationship with.)

	 	 
	6. 	
      if the Subscriber has ticked box F in Section 2 or box E
      in Section 4 above, the Subscriber satisfies one or more of the categories
      of "accredited investor" (as that term is defined in NI 45-106) indicated
      below (please check the appropriate box):

	 	[   ] 	
      (a) a Canadian financial institution as defined in
      National Instrument 14-101, or an authorized foreign bank listed in
      Schedule III of the Bank Act (Canada);

	 	 	 
	 	[   ] 	
      (b) the Business Development Bank of Canada incorporated
      under the Business Development Bank Act (Canada);

	 	 	 
	 	[   ] 	
      (c) a subsidiary of any person referred to in any of the
      foregoing categories, if the person owns all of the voting securities of
      the subsidiary, except the voting securities required by law to be owned
      by directors of that subsidiary;

	 	 	 
	 	[   ] 	
      (d) an individual registered or formerly registered under
      securities legislation in a jurisdiction of Canada, as a representative of
      a person or company registered under securities legislation in a
      jurisdiction of Canada, as an adviser or dealer, other than a limited
      market dealer registered under the Securities Act (Ontario) or the
      Securities Act (Newfoundland);

- 3 - 

	 	[   ] 	
      (e) an individual registered or formerly registered under
      the securities legislation of a jurisdiction of Canada as a representative
      of a person referred to in paragraph (d);

	 	 	 
	 	[   ] 	
      (f) the government of Canada or a province, or any crown
      corporation or agency of the government of Canada or a province;

	 	 	 
	 	[   ] 	
      (g) a municipality, public board or commission in Canada
      and a metropolitan community, school board, the Comite de gestion de la
      taxe scholaire de l'ile de Montreal or an intermunicipal management board
      in Québec;

	 	 	 
	 	[   ] 	
      (h) a national, federal, state, provincial, territorial
      or municipal government of or in any foreign jurisdiction, or any agency
      thereof;

	 	 	 
	 	[   ] 	
      (i) a pension fund that is regulated by either the Office
      of the Superintendent of Financial Institutions (Canada) or a pension
      commission or similar regulatory authority of a jurisdiction of
    Canada;

	 	 	 
	 	[   ] 	
      (j) an individual who either alone or with a spouse
      beneficially owns, directly or indirectly, financial assets (as defined in
      NI 45-106) having an aggregate realizable value that, before taxes but net
      of any related liabilities, exceeds CDN$1,000,000;

	 	 	 
	 	[   ] 	
      (k) an individual whose net income before taxes exceeded
      CDN$200,000 in each of the two more recent calendar years or whose net
      income before taxes combined with that of a spouse exceeded $300,000 in
      each of those years and who, in either case, reasonably expects to exceed
      that net income level in the current calendar year;

	 	 	 
	 	[   ] 	
      (l) an individual who, either alone or with a spouse, has
      net assets of at least CDN $5,000,000;

	 	 	 
	 	[   ] 	
      (m) a person, other than an individual or investment
      fund, that had net assets of at least CDN$5,000,000 as reflected on its
      most recently prepared financial statements;

	 	 	 
	 	[   ] 	
      (n) an investment fund that distributes it securities
      only to persons that are accredited investors at the time of distribution,
      a person that acquires or acquired a minimum of CDN$150,000 of value in
      securities, or a person that acquires or acquired securities under
      Sections 2.18 or 2.19 of NI 45-106;

	 	 	 
	 	[   ] 	
      (o) an investment fund that distributes or has
      distributed securities under a prospectus in a jurisdiction of Canada for
      which the regulator or, in Québec, the securities regulatory authority,
      has issued a receipt;

	 	 	 
	 	[   ] 	
      (p) a trust company or trust corporation registered or
      authorized to carry on business under the Trust and Loan Companies Act
      (Canada) or under comparable legislation in a jurisdiction of Canada
      or a foreign jurisdiction, acting on behalf of a fully managed account
      managed by the trust company or trust corporation, as the case may
    be;

	 	 	 
	 	[   ] 	
      (q) a person acting on behalf of a fully managed account
      managed by that person, if that person (i) is registered or authorized to
      carry on business as an adviser or the equivalent under the securities
      legislation of a jurisdiction of Canada or a foreign jurisdiction, and
      (ii) in Ontario, is purchasing a security that is not a security of an
      investment fund;

	 	 	 
	 	[   ] 	
      (r) a registered charity under the Income Tax Act
      (Canada) that, in regard to the trade, has obtained advice from an
      eligibility advisor or an advisor registered under the securities
      legislation of the jurisdiction of the registered charity to give advice
      on the securities being traded;

- 4 - 

	 	[   ] 	
      (s) an entity organized in a foreign jurisdiction that is
      analogous to any of the entities referred to in paragraphs (a) to (d) or
      paragraph (i) in form and function;

	 	 	 
	 	[   ] 	
      (t) a person in respect of which all of the owners of
      interests, direct, indirect or beneficial, except the voting securities
      required by law are persons or companies that are accredited
    investors;

	 	 	 
	 	[   ] 	
      (u) an investment funds that is advised by a person
      registered as an advisor or a person that is exempt from registration as
      an advisor; or

	 	 	 
	 	[   ] 	
      (v) a person that is recognized or designated by the
      securities regulatory authority or, except in Ontario and Québec, the
      regulator as (i) an accredited investor, or (ii) an exempt purchaser in
      Alberta or British Columbia after this instrument comes into
  force;

The Subscriber acknowledges and agrees that the Subscriber may
be required by the Company to provide such additional documentation as may be
reasonably required by the Company and its legal counsel in determining the
Subscriber's eligibility to acquire the Securities under relevant legislation.

IN WITNESS WHEREOF, the undersigned has executed this
Questionnaire as of the ________day of __________________, ________. 

	If an Individual: 	 	If a Corporation, Partnership or Other Entity:
    
	 	 	 
	 	 	 
	Signature 	 	Print or Type Name of Entity 
	 	 	 
	 	 	 
	Print or Type Name 	 	Signature of Authorized Signatory 
	 	 	 
	 	 	 
	  	 	Type of Entity

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