(Honestly, and I realize this is a stupid bias on my part, I'd trust your site more if the labels on the text boxes lined up with text boxes. I think it is fair to say, however, that a lot of people have silly biases like that, as a lot of time you are just fighting with some gut feeling someone is getting about your site as they are about to convert, and not any appeal to rational argument.)
(Again, though: I am actually the kind of person who tends to just use their credit card willy nilly. I, personally, would have no serious problem signing up for your site as is. However, if you had PayPal as a payment option, I'd use it, and in the end it could actually save you money. If you had Amazon Flexible Payments as a payment option I'd definitely use it, and it would almost certainly save you money.)