<form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post">
<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="6AXHD5FWWMZBC">
<table>
<tr><td><input type="hidden" name="on0" value="Pricing">Pricing</td></tr><tr><td><select name="os0">
    <option value="1 person">1 person $40.00</option>
    <option value="2 people">2 people $60.00</option>
</select> </td></tr>
<tr><td><input type="hidden" name="on1" value="Time">Time</td></tr><tr><td><select name="os1">
    <option value="10:am">10:am </option>
    <option value="1:00pm">1:00pm </option>
    <option value="4:00pm">4:00pm </option>
</select> </td></tr>
<tr><td><input type="hidden" name="on2" value="Date">Date</td></tr><tr><td><select name="os2">
    <option value="August 19 Fri">August 19 Fri </option>
    <option value="August 20 Sat.">August 20 Sat. </option>
    <option value="August 21 Sun">August 21 Sun </option>
    <option value="August 22 Mon">August 22 Mon </option>
    <option value="August 23 Tue.">August 23 Tue. </option>
</select> </td></tr>
<tr><td><input type="hidden" name="on3" value="Passengers Names">Passengers Names</td></tr><tr><td><input type="text" name="os3" maxlength="60"></td></tr>
<tr><td><input type="hidden" name="on4" value="Phone and Email">Phone and Email</td></tr><tr><td><input type="text" name="os4" maxlength="60"></td></tr>
</table>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1" height="1">
</form>