RISK ASSESSMENT FORM

Name:DIMENSION. Dates of working off-campusTBC.. Equipment being used (if any)Cameras, Tripods, Green

ProjectDark Edge. Screen

Do you need to use this form? This form is an important part of planning any activity that takes place . If you intend to work on any academic or production activity off
campus, please fill out this form and discuss any risks with your tutor. In many cases, there will be no risks that can be identified and only SECTIONS A and C will need to be completed. Where there are risks SECTION B must be completed. Only forms completed to a satisfactory standard and signed by your tutor will be accepted. Please remember that you may not be allowed to proceed with your off-campus activity if this form is not completed.

Section A
A number of potential hazards associated with working off campus are listed below. Examine each in the light of your activity and tick yes or no.

Y 1 2 3 4 5 6 7 8 9 Lone working Cabling Hoists Lighting Explosives/pyrotechnics Smoke Effects Working in poor visibility Scaffolds Working at heights
Y Y

N
N

Y 10 11 Working in/near water Beach/Sand Vehicles /Traffic Aircraft Animals Props Costumes Glass Electrical Cables/ Pylons
Y Y

N
N N pos sib ly N N

Y 19 20 21 22 23 24 25 26 27 Caves/tunnel/quarries Stunts Fight sequences Violent interviewees Actors/Performers Child performers Drug Users Criminals Guns/Firearms
Y

N
N N

12 13 14 15 16 17 18

N Y N N N N

N N N N N

Po ssi bly N

28. Use this space to detail any other potential hazards associated with your assignment

Section B*

If you ticked any Y boxes in Section A, then please complete Section B. Hazard no: 4 Risk give further details. ie there is a risk that... Light heats up Control what are you doing to minimise the risk? Turn it off every 5 mins Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? meeting Hazard no: Risk give further details. ie there is a risk that... 15

Injuries can occur from sharp edges Control what are you doing to minimise the risk? Keep the use of said objects to a minimum Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? Meeting,

Hazard no: Risk give further details. ie there is a risk that... Potential to trip on longer articles of clothing Control what are you doing to minimise the risk? Try avoid using clothes long enough to trip on, careful use when they are used Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? meeting

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Hazard no: Risk give further details. ie there is a risk that... Accidental injuries Control what are you doing to minimise the risk? Rehearsal beforehand to reduce risk of a mess-up Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? Meeting, rehearsal sessions Hazard no: Risk give

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further details. ie there is a risk that... Actor injures self on set Control what are you doing to minimise the risk? Safety briefing before start of filming Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? meeting

Hazard no: Risk give further details. ie there is a

risk that... Someone could trip Control what are you doing to minimise the risk? Keep the cables out of the way Communica tion what efforts are you making to communicat e the risk to members of the team, the general public etc? meeting Section C The following students are working on this project: Elliot Doyle, Elliot Hudson-Owen, Alex Borril, Ben Phillips To the best of my belief the information given is correct and complete Signed (STUDENT) ______________________________________________________ ____ Date: _______ / ________ / ________ Based on the information supplied, I hereby authorise this activity: Signed (TUTOR) ___________________________________________________________ Date: _______ / ________ / ________

* Please complete Risk Assessment Continuation sheets if additional space is required.