Indiana Wedding & Prom Tuxedo Rentals

Photographer & Videographer: Derby Photography & TJ21 Media Group

Louie's Tux Shop Location

Provide the location that is closest to you.

Model First Name

Model Last Name

Mobile Contact Number

Email Address

Model Height

Model Weight

SCHEDULE AVAILABILITY FOR SUNDAY 10/26

Note: The more time you are available the more camera work you get in.

I am available all day/anytime between 9:00 and 4:00. If you check this box you should skip the next section of radio buttons.

Model Release

By signing this release I hereby give the Louie's Tux Shop, Photographer and Assigns my permission to license the Images/ video and to use the Images/video in any Media for any purpose (except pornographic, defamatory, libelous or otherwise unlawful) which may include, among others, advertising, promotion, marketing and packaging for any product or service. I agree that the Images may be combined with other images, text and graphics, and cropped, altered or modified.

I agree that I have no rights to the Images/video, and all rights to the Images belong to the Photographers, Louie's Tux Shop and Assigns. I acknowledge and agree that I have no further right to additional Consideration or accounting, and that I will make no further claim for any reason to Louie's Tux Shop, Photographer and/or Assigns. I acknowledge and agree that this release is binding upon my heirs and assigns. I agree that this release is irrevocable, worldwide and perpetual, and will be governed by the laws of England, excluding the law of conflicts.

Model Printed Name

Model Date of Birth

Model Signature

To be completed by the model's parent or lgal guardian regardless of age

By completing the portion below I authorize my son or daughter to participate in the photo shoot and agree to all the terms stated above.

Parent/Guardian Printed Name

Parent/Guardian Signature

Date of Signature

Model Release Form

Model Release