FORM RA 002 (adapted for Student Media Productions)

Equipment booking
Name of hirer

Chloe Coleman

Facility / equipment required

Catalogue
code

Description

Hours/day
s

DLSR camera.
Go-Pro camera.
Tri-pod.
Zoom mic.

5 hours
5 hours
5 hours
5 hours

Unit
cost

Cost

Total

Issue
Return

Date
24/06/15
24/06/15

Time
11am
4pm

Please give as much notice as possible. Location filming requests MUST be submitted at least
48 hours in advance to ensure batteries can be charged etc.

Page 1 of 7

FORM RA 002 (adapted for Student Media Productions)

Call sheet
Production title
Call sheet for (date)

The Patient Film trailer

Production team
Names

Roles

Contact details

Chloe Coleman

Director, editor & camera op.

07511772304

Actor

07881309065

First aider

N/A

Actors
Jordan Liddell

Base address and contact details:

Wiltshire College Chippenham 01249 464644

Location address: Wiltshire College Chippenham

Map attached. N/A
Access info: Enter through front enterance.
Contact details: 01249 464644
Travel arrangements: N/A

Times
Meet time at base 11AM
On location 11AM
Shoot time (s) and scene numbers ALL
Planned breaks and catering arrangements N/A
Projected wrap time 4PM
Back at base time 4PM

Weather report (if outside)

N/A
Special considerations with regard to location/weather/activities etc
N/A

Page 2 of 7

FORM RA 002 (adapted for Student Media Productions)

Page 3 of 7

FORM RA 002 (adapted for Student Media Productions)

RISK ASSESSMENT FOR LOCATION FILMING

DATE OF
ACTIVITY

TASK / ACTIVITY

DATE
ASSESSED

Shooting a short film trailer.

24/06/15

BRIEF DESCRIPTION
A short film trailer about a biological outbreak in world war 2.

RISK RATING
(likelihood consequence = )

See Risk Assessment Assistant (Page 3) for scoring.

Include the risk word (i.e. acceptable, adequate, tolerable, unacceptable).

2

NUMBER OF PEOPLE UNDERTAKING TASK

PEOPLE

DURATION OF TASK

PERSONNEL PROFILE / TRAINING GIVEN

PERSONNEL

INSTRUCTED

PERSONNEL

5 hours

INSTRUCTED

PERSONNEL

INSTRUCTED

STAFF

TALENT

YOUNG PERSON

STUDENT

CONTRIBUTORS

VISITOR

PUBLIC

PERSONNEL
WORKING ALONE

DISABLED

SPECIALIST TRAINED
PERSONNEL

CONTROL MEASURES IN PLACE (Guarding, Safe Systems of Work, PPE, etc)

N/A

TO BE COMPLETED BY STAFF ASSESSOR(S) (Ctrl+Tab to add tab stops between columns)

EXTRA ACTIONS REQUIRED TO CONTROL SIGINIFICANT RISKS

ACTIONED BY

DATE

STUDENT ASSESSOR(S)
STAFF ASSESSOR(S)

Page 4 of 7

FORM RA 002 (adapted for Student Media Productions)

HAZARD IDENTIFICATION
HAZARD TYPE
1. Mechanical / Physical Hazards

PRESENT
YES

NO

ACTIVITY / TASK

COMMENTS

HAZARD TYPE
4. Production Hazards

1.1 Slips / Trips / Falls

4.1 Stressful Postures

1.2 Vehicles

4.2 Lifting / Handling

1.3 Camera Grip Equipment

4.3 Inadequate Breaks

1.4 Falling Equipment

4.4 Restricted Visibility (viewfinder)

1.x Other Mechanical Hazards

4.5 Camera Tracking/Crabbing

2. Electrical Hazards

YES

NO

COMMENTS

4.6 Working at Height

2.1 Direct Contact

4.x Other Workplace Hazards

2.2 Indirect Contact

5. Hazardous Substances

2.3 Short Circuit / Overload

5.1 Explosive / Biological / Chemical

2.4 Source of Ignition

5.2 Substances in set construction

2.5 Proximity to Water

5.x Other Hazardous Substances

3. Production Activities

YES

NO

6. Environmental Hazards

3.1 Extreme Sports

6.1 Localised Hot / Cold Surfaces

3.2 Animals (working with or proximity to)

6.2 High / Low Ambient Temp.

3.3 Fight sequences

Make sure that all fight sequences

are properly rehearsed before
shooting be mindful of the
environment around them while
performing the sequence.

6.3 Poor Lighting

3.4 Potential Intervention from Public

6.4 Confined spaces

3.5 Potential for Assault

6.5 Poor Weather

3.6 Noise pollution

6.6 Uneven/Slippery Surfaces

3.7 Smoking

6.7 Unsafe structures

3.8 Alcohol

6.8 Sharps & breakages

3.x Other Production Activity Hazards

6.x Other Environmental Hazards

Page 5 of 7

FORM RA 001

RISK ASSESSMENT ASSISTANT

These are the basic terms that apply to a Risk Assessment:
A hazard is anything that has the potential to cause harm. This could be something as specialised as a piece of
complicated machinery, or as commonplace as a cup of coffee. If it could be harmful in any way, then its a
hazard.
A hazardous event takes place when someone or something interacts with the hazard and allows it to cause
harm. Take a hole in the ground for example. The hole (the hazard), by itself isnt causing any harm, but if
someone tripped over it (the hazardous event) then it would become harmful. Every hazardous event has a
likelihood and a consequence.
Likelihood is a measure of the chance that the hazardous event will occur. If the hole is in a busy area, such as
a shop entrance, its more likely someone will trip over it. However if its in an area that doesnt get a lot of traffic,
such as a back yard, tripping over it would be less likely.
The consequence is the outcome of the hazardous event. If you tripped over a hole, there could be several
possible outcomes; you might land on your feet with no damage at all, you might drop whatever you are carrying,
or perhaps you could end up with a sprained ankle or even a fracture.
Risk is the combination of the likelihood of a hazardous event occurring and the consequence of the event.

Risk = likelihood x consequence

Below is a table to help you work out the score for the likelihood and consequence. Once you have done this,
multiply the two numbers to get the Risk Rating.

Likelihood

Risk
Score

Consequence

Very unlikely might happen once in 5 years

No injury

Unlikely would not happen in 2-3 years

Minor - minor injury requiring first aid

Fairly Likely would expect to happen once a year

Moderate - up to three days absence

Likely could occur 2-3 times a year

Major more than three days absence

Very Likely likely to happen 2-3 times a week

Catastrophic Death or multiple deaths

Risk Matrix this is used for estimating and evaluating the risk it is a commonly used tool. Usually the higher the
risk level, the more serious the risk and the more likely youll need to take action.

Page 6 of 7

 CONSEQUENCE

FORM RA 001

10

15

UNACCEPTABLE Stop the activity and make

20 immediate
25
improvements
17-25

12

16

12 TOLERABLE
15
look to improve within a specified
10-16
timescale
8
10

LIKELIHOOD

20

5
ADEQUATE Look to improve at next review
5-9

1-5
If you are still not sure or just have a question, please do not hesitate in contacting the Health & Safety
Department We are here to help!

Page 7 of 7