MOKASA Community Playdate
Please complete the following form if you plan to attend the MOKASA community playdate!  

When: Wednesday, April 12 9:30-11:30 am 
Where: Kirkwood Community Center Small Gym

Join us for music, movement, crafts & more! This event if for families of children ages 0-5. Admission is free with an optional donation of non-perishable food items or diapers.

Donations from this event will benefit:
Kirk Care (canned meat and fruit, peanut butter, boxed meals, any non-perishable food items)

St. Louis Area Diaper Bank Any diapers, any size, unopened or opened

About MOKASA
MOKASA is a community of moms in Kirkwood, Glendale, Oakland, Des Peres and Warson Woods. We meet for play dates, activities, educational meetings, and moms nights out. We also perform community service and provide member support. All moms who live within the boundaries are welcome! Please email mokasa.board@gmail.com for information on joining or questions about this event.

Name (First and Last) *
Email *
Where are you a resident?  *
Phone number *
Child #1 Name *
Child #1 Age *
Child #2 Name
Child #2 Age
Child #3 Name
Child #3 Age
Child #4 Name
Child #4 Age
Child #5 Name
Child #5 Age
Please list any additional children and their ages. 
How did you hear about our event?  *
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