You do not need a PayPal account to checkout:
Add item to your cart, on the next page hit checkout, complete the customer details form then hit continue, make sure everything is correct then hit place order & pay, it will prompt you to pay with PayPal but if you look to the bottom you will see pay with debit or credit you can use your major debit or credit card to pay by clicking that option.

The download is a purchase acknowledgement. You can choose to download if you would like for your records but the completed design will be emailed to you. This is a custom order for a t-shirt design