Risk Assessment Form Part A

Reference:
[enter reference number]]

Sign-off status

[planning/approved etc]

Assessment summary details

Assessment title

Final Production task

Division:* Series/ Prod/ nit: Responsi!le "anager: Address/Tel:

Department:* Programme/Area: #ontact office: Address/Tel:

Date assessment created

25/11/2013

#onfidential risk assessment$

%&

Assessment &utline

Filming a chase scene that then turns into a fight scene 29/11/2013
30/11/2013

Assessment start date #ountry location

Revie' / (nd date

Cambridge Alley and yard behind the shops on the corner of Cherry inton and Perne !oad"

)ostile / travel advisory$ %+: ,f t-e country location selected is .)ostile/ you are re0uired to: complete t-e ++# &verseas )ig- Risk Assessment Form

*ocation details

#re' / team

#ichael $bbs% &irector and ca'era 'an

Attac-ments

Production (chedule

Assessor1s2

Michael Ibbs

Assessor safety competence Date signed-off *

Aut-oriser1s2 *

Mr Sheppard

Distri!ution

Michael Ibbs
&ata Protection Act: Personal infor'ation collected for the purposes of risk assess'ent )ill be used to identify those at risk% and those in*ol*ed in controllin+ risk% fro' this or si'ilar acti*ities and to fulfil the ,,C-s obli+ations under ealth and (afety policy and le+islation" $t )ill be retained for up to . years after the e/piry of the acti*ity" $t 'ay be shared )ith other or+anisations% includin+ our a+ents and contractors% )ith )ho' the risk or the control of risk is shared"

Activity and )a3ard Summary

Activity Filming c-ase and fig-t scene 4-o (5posed T)o actors )a3ards Fi+htin+ in0ury% Truck Activity Risk Rating *o'

#omments log
4-o !y Date / time received #omments Assessor response Date/ time responded

Risk Assessment Form Part +

.

Reference:

[enter reference number]]

Sign-off status

planning

A#6,7,6,(S: 1hat are you doin+% )here% for ho) lon+ and )ho )ill be in*ol*ed2 Co'plete the fields in the for' belo)3" Activity 6itle: Activity Description: (hift

)A8ARDS 9 #&%6R&*S: o) could so'eone beco'e hurt or 'ade ill and ho) are you +oin+ to pre*ent this fro' happenin+2

&ne actor c-asing do'n anot-er t-roug- an alley and t-en fig-ting -im in t-e small yard:

*ist t-ose managing t-is Activity and t-eir competence: 4-o 9 -o' many are at risk from t-is Activity$

#ichael $bbs 4 &irector

6'o actors

)a3ards o) could so'eone beco'e hurt or 'ade ill Accidental in0ury due to the fi+htin+ in the scene"

#ontrol measures o) are you +oin+ to pre*ent this fro' happenin+2 Actors )ill be sho)n beforehand )here and ho) to stand and not to put any real force behind blo)s as the ca'era )ill not directly sho) the' +ettin+ hit" (cene )ill be rehearsed 'ultiple ti'es"

Truck 'ay back into alley and hit actors

The fil'in+ in the alley )ill take place )hen no trucks are scheduled to arri*e" 1hen in the yard the ca'era and actors )ill be a)ay fro' the entrance of the alley and )on5t be at risk"

Risk *evel*: After your controls ha*e been applied )hat is your assess'ent of the risk le*el of this acti*ity2

*o'