Krewe of Bitcoin Bay Interest Form

1
Name* This field is required.or nym
First Name
Last Name
2
Email* This field is required.We'll need to contact you somehow
example@example.com
3
Phone NumberIf you'd be so kind
Please enter a valid phone number.
4
What can we interest you in?* This field is required.
Throwing beads off the Parade Float
Sponsoring the invasion
The local meetup
5
Manning the ship comes with responsibilityInvasions arghn't cheap and the bureaucrats have forms to fill out first
I'm inWalk the plank
6
Want to pay in Bitcoin?you know you want to
YESNO
7
Good on Ye, use the link belowhttps://btcpay0.voltageapp.io/apps/3T7zeFRSZez3CPyVNFu7JyKG5sYy/pos
example@example.com
8
My Products
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Krewe Member DuesJoin the Krewe of Bitcoin Bay and set sail on the world's first Bitcoin Parade float
$1,000.00Edit
Back
Enter Coupon
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
ACH Bank Transfer
Account Holder Name
Afterpay
After submitting the form, you will be redirected to the Afterpay to complete the payment process.
Should be Empty: