FORM RA 002 (adapted for Student Media Productions)

Equipment booking

Name of hirer Joe Hornsby

Facility / equipment required

Catalogue Description Hours/days Unit Cost
code cost
XA25 Monday
to
Thursday

Tripod

Total £0.00

Date Time
Issue Monday 21st of May 1:00pm
Return Thursday 24th of May 12:30pm

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.

[Type here]
 FORM RA 002 (adapted for Student Media Productions)
Call sheet

Production title FMP Project

Call sheet for (date)

Production team
Names Roles Contact details

Actors

First aider

Base address and contact details:

26 portland way
07741 300851

Location address: 26 Portland Way

Times

Weather report (if outside)

cloudy

Special considerations with regard to location/weather/activities etc

[Type here]
 FORM RA 002 (adapted for Student Media Productions)
DATE OF
RISK ASSESSMENT FOR LOCATION FILMING ACTIVITY
21st – 24th of May

TASK / ACTIVITY DATE

14th of May
Filming for my final project ASSESSED

BRIEF DESCRIPTION I will possibly be filming in two different locations, my house and possibly my friends if that’s alright
with them but definitely my house. There won’t be any electrical hazards, there could be falling or tripping with the stairs but
other than that there’s not major risks.

See Risk Assessment Assistant (Page 3) for scoring.

RISK RATING
(likelihood × consequence = )
Include the risk ‘word’ (i.e. acceptable, adequate, tolerable, unacceptable).

PEOPLE 6 NUMBER OF PEOPLE UNDERTAKING TASK

DURATION OF TASK
PERSONNEL PROFILE / TRAINING GIVEN

PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED PERSONNEL INSTRUCTED

STAFF 0 TALENT YOUNG PERSON 0

STUDENT CONTRIBUTORS 0 VISITOR 0

PERSONNEL
PUBLIC 0 0
WORKING ALONE

SPECIALIST TRAINED
DISABLED 0 0
PERSONNEL

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

To be careful when moving about so slips, trips and falls don’t happen. My three dogs could be a problem
but I’d make sure they are in a separate room to me filming.

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)

[Type here]
 FORM RA 001
ACTIVITY / TASK
HAZARD IDENTIFICATION
HAZARD TYPE PRESENT HAZARD TYPE PRESENT
COMMENTS COMMENTS
1. Mechanical / Physical Hazards YES NO 4. Production Hazards YES NO

yes Potentially 4.1 Stressful Postures no

1.1 Slips / Trips / Falls
1.2 Vehicles No 4.2 Lifting / Handling no

1.3 Camera Grip Equipment no 4.3 Inadequate Breaks no

1.4 Falling Equipment no 4.4 Restricted Visibility (viewfinder) no

1.x Other Mechanical Hazards no 4.5 Camera Tracking/Crabbing no

2. Electrical Hazards YES NO COMMENTS 4.6 Working at Height no

2.1 Direct Contact no 4.x Other Workplace Hazards no

2.2 Indirect Contact no 5. Hazardous Substances YES NO COMMENTS

2.3 Short Circuit / Overload no 5.1 Explosive / Biological / Chemical no

2.4 Source of Ignition no 5.2 Substances in set construction no

2.5 Proximity to Water no 5.x Other Hazardous Substances no

3. Production Activities YES NO 6. Environmental Hazards YES NO COMMENTS

3.1 Extreme Sports no 6.1 Localised Hot / Cold Surfaces no

3.2 Animals (working with or proximity to) yes My three dogs possibly 6.2 High / Low Ambient Temp. no

3.3 Fight sequences no 6.3 Poor Lighting no

Yes if rooms count as confined

3.4 Potential Intervention from Public no 6.4 Confined spaces yes no
spaces

[Type here]
 FORM RA 001
3.5 Potential for Assault no 6.5 Poor Weather no

3.6 Noise pollution no 6.6 Uneven/Slippery Surfaces no

3.7 Smoking no 6.7 Unsafe structures no

3.8 Alcohol no 6.8 Sharps & breakages no

3.x Other Production Activity Hazards no 6.x Other Environmental Hazards no

[Type here]
 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 it’s 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 isn’t 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, it’s more likely someone will trip over it. However if it’s in an area that doesn’t 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.

Risk
Likelihood Consequence
Score

Very unlikely – might happen once in 5 years 1 No injury

Unlikely – would not happen in 2-3 years 2 Minor - minor injury requiring first aid

Fairly Likely – would expect to happen once a year 3 Moderate - up to three days’ absence

Likely – could occur 2-3 times a year 4 Major – more than three days’ absence

Very Likely – likely to happen 2-3 times a week 5 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 you’ll need to take action.

[Type here]
 FORM RA 001

UNACCEPTABLE – Stop the activity and make

5 10 15 20 25
17-25 immediate improvements
 CONSEQUENCE 

4 8 12 16 20

3 6 9 TOLERABLE
12 15– look to improve within a specified
10-16 timescale
2 4 6 8 10

1 2 34 5
ADEQUATE – Look to improve at next review
 LIKELIHOOD 
5-9

ACCEPTABLE – no further action but ensure

1-5 controls are maintained

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!

[Type here]