Personalized Video Request Form

Personalized Video Request Form

Get a personalized video from Daddy Burt Bronx: Winner of FishTank Season 3 . B.U.R.T: Black Urban Raw Top. 36 y/o. 6 ft. 200+ lb. Size-12 Feet. West African: Ghana. Gym Coach. NJ Firefighter w/ Autism. Openly Bisexual (Dom Top)
NAME: Type in the name you prefer to be called.*

First NameLast Name
EMAIL:*
PHONE NUMBER
Cameo Intro
THIS JOTFORM VS CAMEO

If you want the best value for your custom video, book through this JotForm instead of Cameo:
- Cameo App: Takes a huge 50% cut due to Apple/Google in-app purchase fees, meaning I get just half of what you pay.
- Cameo Website: Takes 30%, so I only receive 70% of your payment.
- This JotForm: Only 3% in fees, meaning I keep 97% of what you pay
For example, on a $100 order:
- Cameo App: $50 in fees
- Cameo Website: $30 in fess
- JotForm (Stripe): Only $3 in fees
By booking through this JotForm, your money goes directly to me instead of unfair platform fees, allowing me to focus on creating the best possible video for you.

Burt Bronx Has Over 60 Five-Star Reviews on His Cameo Profile:

https://www.cameo.com/burt_bronx
Myself (Male)Myself (Female)Someone Else (Male)Someone Else (Female)Couple: Male and FemaleCouple: Male and MaleCouple: Female and FemaleGroup: Mixed Genders
NAMES OF RECIPIENTS: List the name(s) of the recipient(s) of this video*
He / Him / HisShe / Her / HersThey / Them / TheirsNo Preference
Portrait (Vertical)Landscape (Horizontal)No Preference
Personalized MessageBirthday GreetingHoliday GreetingAnniversary VideoWedding CelebrationGraduation TributeJob Promotion CelebrationApology VideoCorporate Event VideoMarketing and Promotional VideoGet Well Soon MessageOther
NoneNew Year’s DayValentine’s DaySt. Patrick’s DayEasterMother’s DayFather’s DayPride MonthIndependence Day (4th of July)HalloweenThanksgivingHanukkahChristmasKwanzaaNew Year's EveOther
Fan ShoutoutMotivational MessageCustom Script PerformanceDance VideoBurting Off VideoStacy’s Mom ParodyB.U.R.T. Style AcronymOther
No PreferenceFunny / EnergeticSerious / ProfessionalRomantic / SexualOther
No PreferenceDefault: Burt BronxDaddy BurtCoach BurtDark BurtMAGA BurtBased BurtPrisoner BurtQueer BurtOther
PERSONALIZED VIDEO FROM BURT*
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Personalized Video from Burt
Get a personalized video from Daddy Burt Bronx: Winner of FishTank Season 3.

$120.00 QuantityDeadline

Total

$0.00
24 hours (1 day)48 hours (2 days)72 hours (3 days)4 Days (Default)
CURRENT DATE AND TIME (EST)

MonthDayYear
Date
Hour MinutesAM/PM Option
DEADLINE FOR VIDEO (EST)

MonthDayYear
Date
Hour MinutesAM/PM Option
SCRIPT: Provide a word-for-word script for Burt to say in the video. If no script, give clear instructions on what you want included.*
FILE UPLOAD: Upload any photos or files you believe may be helpful

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SOCIAL MEDIA: Please list your social media usernames
Twitter (X) Username
Instagram Username
Facebook Username
YouTube Username
TikTok Username
Twitch Username
Discord Username
BURT SOCIALS
- Official Website: https://burtbronx.com
- YouTube: https://burtbronx.com/youtube
- TikTok: https://burtbronx.com/tiktok
- Discord: https://burtbronx.com/discord
- Twitter (X): https://burtbronx.com/twitter
- Facebook: https://burtbronx.com/facebook
- Instagram:https://burtbronx.com/instagram
- Threads:https://burtbronx.com/threads
- Twitch: https://burtbronx.com/twitch
- Kick: https://burtbronx.com/kick
Should be Empty:

Personalized Video Request Form

SOCIAL MEDIA: Please list your social media usernames