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Film & TV Production

APPROVED BY TUTOR (Print


Name):

Equipment Booking Form


Collection and return times may be

APPROVED BY TUTOR
(Signature) :

Kit Number:Technical Team

amended by the technical team at


the point of handing paperwork in
at the Hatch (this is to be done

USERNAME:
2090120

Location Name:
Date:
Risk LocA
A am
Collection date: 9/11/15
Collection time: 9:30
Return date: 17/11/15
Return time: 10:00am
Silver Street
13/11/15
Bradford Road
13/11/15

Other:
(state)

48hrs prior to the collection date).

Add in here a complete


list of the Locations with
Dates and indicate
Documentation covered
by this booking. Your
Module Tutor will check
this against the
documentation provided
Equipment
on the
Crew and
Production Paperwork

Camera (specify
model)
Camera battery
Tripod
Sound kit
Sound mixer
Boom pole
Field monitor
Lighting kit

Clapper board & pen


Other Items:

Number
1
1
1
1
1

Issued

Returne
d

Problems/Faults/Damage

Role/s

Crew Member
Name

Telephone

Email

In order for a booking to be signed off by your Module Tutor and accepted by the Technical Team, all
the roles being undertaken by individual Crew Members must be stated below, including the role
booking out the equipment. This is to ensure that the right Crew Members are collecting the right
kit for their shoot. It also provides the Technical Team with contact details, should there be any
issue with the provision of equipment or technical problems with what has been provided.
Only YSJ email accounts should be used for module work. If you are called by a different name from
your email account, put this in brackets.
I hereby undertake with the Governors of the University of York St John the following:
- That I am a student of York St John University and Member of the Crew as stated above;
- To retain the Equipment in my exclusive possession and control during the period of loan;
- To use the equipment only for activities agreed with my Module Tutors and in accordance with the
conditions set out below;
- That Risk Assessment Forms have been prepared to support the appropriate use of this equipment at
the specific times and locations covered by this booking, and that these have been approved and
agreed with my Module Tutors;
- I do not foresee any significant hazards other than those noted;
- I have carefully considered all the production activities and the findings of the Risk Assessment
attached, and further communicated these findings to the production group and others who may be
affected e.g. site owners, engineers, contractors, freelancers, resources, etc.;
- I and other crew members have attended technical demonstrations which provided training in the use
of the equipment and Health & Safety considerations;
- That only trained students or staff of York St John University will be using this equipment (students
MUST have relevant stamps on their production card);
- On being issued, to check that I have received the agreed equipment and that it is in appropriate
working order;
- Fair wear and tear accepted. To keep the Equipment in its condition at the date hereof;
- To notify the Technical Team of any faults, problems or damage to the Equipment;
- To indemnify the University in the respect of any loss
Print Name:
or damage to the Equipment or any part thereof
howsoever and by whosoever caused during the
period of loan;
Signature:
- To return the Equipment to the University forthwith upon
demand being made and in the event not later than the
return date and time specified above.
Those responsible for specialist equipment must sign in the appropriate place below to identify
themselves as both trained on the equipment and responsible for appropriate and safe working practices
in its use:

Equipment
Lighting
JIB
Track
Radio Mics
Other

Role

Name

Signature