Hertford Men's Shed Membership request form

Hertford Men's Shed Membership Request Form

For all new membership inquiries, please fill out the form below. Your personal information and data will be added to our online member database and kept confidential under our Privacy Policy
Full Name:*

First NameLast Name
Phone number *

Your preferred phone numberOptional - other phone number / home phone
Email contact:*
Date of birth (please state as xx/xx/xxxx):*
Please select your ethnicity*
Your postcode:*
I would like to be considered for a role in Hertford Men Shed Committee/ Development group?*

YesNo
Medical conditions - Please detail any medical conditions, allergies or medication you would like to inform us about. We require this information for our risk assessments, to ensure we are prepared in case of emergency and to ensure the Shed operates safely.*
Please state any medical details of which we should be aware of in case of emergency Eg - diabetes, epilepsy, epi pen/ asthma inhaler
Do you require any reasonable adjustments to access the Shed? This may be a ramp, special seating etc ?*
Do you have a physical or mental health condition lasting longer than 12 months ?*

YesNo
If you answered Yes to the above - how does this condition limit your day to day activities?
Would you be interested in attending a Men Shed members only, Chair yoga/ seated exercise class (We are looking into starting this class in September/October 2025 if we have enough interest from members) ?*

YesNo
Emergency contact details *

Name/ relationship to you Contact phone number in case of emergency
Doctors Surgery *
Please tick what your availability would be to attend Men Shed sessions*

Daytime Workshop sessions (Once up and running between 10-2PM)Weekend Workshop sessions (In the future)
Please tick what Men Shed activities you are interested in ...*

WoodworkBike RepairsFurniture RepairsElectrics/ mechanicsCommunity 'Repair Cafe' eventsSupporting with other Community ProjectsAttending local Events (Eg Supporting with running a stall at Hertford Market
Interests & Skills - Please provide us with a summary of your interests/ skills that you may like to bring to Hertford Men's Shed *
How did you find out about the Shed? Eg Facebook, word of mouth, Doctor, Referral, Event...*
Declaration*

I hereby declare that all the information I have provided is correctI agree to abide by the Hertford Men Shed Code of Conduct, Shed Rules and Heath and Safety PolicyI understand that failure to follow Shed rules may result in my membership being revoked.I understand that all new members are required to complete an in person induction within their first visitI agree to allow Hertford Men's Shed to contact me about Shed activities and meetings onlyI understand that from time to time photographs and videos may be taken within the Shed. I consent to their use by Hertford Men Shed in publications, newsletters and in the media to highlight the good work of Men’s Sheds. I understand that this consent can be withdrawn at any time in writingI understand that Hertford Men Shed Annual Membership is £10 per year - upon completion of this form, please pay your membership when attending your next Hertford Men Shed session/ event
I understand that the activities of the Shed carry hazards and I will be doing them at my own risk. I understand that my safety is my own responsibility and confirm that I will comply with the Shed’s Health and Safety policy.*

I hereby consent that I have read, understood and agree to the above statement.
Please provide a signature to signify that you have read and agree to abide by the Hertford Mens Shed policies outlined above. *

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Hertford Men's Shed Membership Request Form