INVESTOR SUBSCRIPTION AGREEMENT FOR B2 HEALTH, INC.
INVESTOR SUBSCRIPTION AGREEMENT
FOR
Persons interested in purchasing shares ("Shares") of Common Stock of B2 Health, Inc., a Delaware corporation (the "Company") must complete, execute, and deliver this Subscription Agreement (the "Agreement") along with their check made payable to “B2 Health, Inc. Escrow Account, Corporate Stock Transfer, Inc., Escrow Agent” to:
0000 X. Xxxxx Xxxx., Xxxxx 000
Xxxxxxxx Xxxxxxx, XX 00000
If and when accepted by the Company, this Agreement shall constitute a subscription for shares of Common Stock, $.0001 par value per share of the Company.
The Company reserves the right to reject in its entirety any subscription which is tendered or to allocate to any prospective purchaser a smaller number of shares than the prospective purchaser has subscribed to purchase. In such event, the Company will return to you at the address set forth in this Agreement your payment (or a pro rata portion of your payment, if such subscription is rejected only in part), without interest or deduction.
An accepted copy of this Agreement will be returned to you as your receipt, and a stock certificate will be issued to you shortly thereafter.
I/we hereby tender this Agreement for the purchase of ________ shares, at a price of $1.00 per share. With this Agreement, I/we tender payment in the amount of $________ ($1.00 per share) for the shares subscribed.
In connection with this investment in the Company, I/we represent and warrant as follows:
a. Prior to tendering payment for the shares, I/we received and reviewed the Company's prospectus dated March ____, 2007, and have relied on no other information or materials in reaching my/our investment decision.
b. I/we represent and warrant that no broker-dealer or member of the National Association of Securities Dealers, Inc. has participated or been involved in any manner whatsoever in my investment decision.
c. I am/we are bona fide resident(s) of
____________________________
(State)
_____________________________
(Country)
d.
I/we understand and agree that this subscription agreement is subject to the terms and conditions of the Fund Escrow Agreement more fully described in the Company’s prospectus
Please register the shares which I am/we are purchasing as follows:
Name: _____________________________________________
As (check one):
____
Individual
____
Tenants-in-Common
____
Partnership
____
Joint Tenants
____
Corporation
____
Trust
____
Minor with adult custodian
Under the Uniform Gift
to Minors Act
For the person(s) who will be registered shareholder(s):
Name: __________________________
Telephone: ______________________
Social Security or Taxpayer ID number: ______________________________________
Street Address:
________________________________________
_____________________________________________________
City State Zip
Date of Birth: ________________________
______________________________________
____________________________
Signature
Date
ACCEPTED BY: B2 HEALTH, INC.
By: ____________________________________
_____________________________
Date:
Its: ____________________________________
