RISK ASSESSMENT FORM

Name..Andrew Horne. Project..FMP Dates of working off-campus.. Equipment being used (if any)

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 Y

N 10 11
N

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

N
N N N N N

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

N
N N N N N N N N N

12 13

N N N N N

14 15 16 17 18

N N N

25 26 27

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: 2 Risk give further details. ie there is a risk that... Potential trip hazard with the cabling from lights. Control what are you doing to minimise the risk? I will organise the cables so they do not cut off any walkways and I will inform people that the cables are there. Communication what efforts are you making to communicate the risk to members of the team, the general public etc? I will inform everybody in the class that there are cables running across the room so be careful of them. Hazard no: 4 Risk give further details. ie there is a risk that... There is potential that people will trip over the lights or possibly the lights get to hot and melt things/break. Control what are you doing to minimise the risk? To minimize the risk I will inform everybody that the lights are where they are. I will also make sure that the lamps are not in contact with any other objects. I will also turn the lights off every now and then to prevent them getting to hot. Communication what efforts are you making to communicate the risk to members of the team, the general public etc? I will let everybody in the class know that im using lights and I will tell them where they are. Section C The following students are working on this project: Andrew Horne

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: _______ / ________ / ________