Eco Bear Biohazard Cleaning Company is offering one adult and one child ticket for a one day pass to Disneyland in Anaheim for a family that is a victim of crime.

Applicants must be a resident of Los Angeles, San Bernardino, Riverside, Orange, or Ventura counties.

One winner will be chosen on August 28, 2019 and then every two months thereafter.

To apply, fill out the form below.

Your personal information will only be viewed by Emily Kil and Raymond Magno, husband and wife owners of Eco Bear Biohazard Cleaning Company. If privacy is of concern, then you are welcome to submit an initial for your last name. However, we do need a valid phone number or email address to contact you if you win. If you are not selected as the winner, we will keep your info on file for six months for consideration on the following months’ giveaways. After that time, we’ll delete your information.