RISK ASSESSMENT FORM

Name:Jonathan Colby Pierre. May.. ProjectRacism Documentary . Voice Recorders Dates of working off-campus 20th April -11th Equipment being used (if any)Camera , Tripod ,

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

N
N N N N N N N N N

Y 19 Caves/tunnel/quarries

N
N N N N N N N N N

20 Stunts 21 Fight sequences 22 Violent interviewees 23 Actors/Performers 24 Child performers 25 Drug Users 26 Criminals 27 Guns/Firearms

12 13

N N N N N

14 15 16 17 18

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: 1 Risk give further details. ie there is a risk that... There is a risk that I could be attacked or lose equipment. Control what are you doing to minimise the risk? To prevent this risk I will return the equipment after Ive finished using it immediately. Communication what efforts are you making to communicate the risk to members of the team, the general public etc? I will have a briefing with each of the contributors before each shoot. Ill also inform Festival Place if I tend to film the public before I do it. Hazard no: 2 Risk give further details. ie there is a risk that... There is a risk that I could or a contributor could trip over the cabling. Control what are you doing to minimise the risk? I will tape down all wires and hide them away from view. Communication what efforts are you making to communicate the risk to members of the team, the general public etc? I will have a briefing with each of the contributors before each shoot. Section C The following students are working on this project: Jonathan Pierre To the best of my belief the information given is correct and complete Signed (STUDENT) Based on the information supplied, I hereby authorise this activity: Signed (TUTOR)

__________________________________________________________ Date: _20______ / _____04___ / ______2012__

* Please complete Risk Assessment Continuation sheets if additional space is required.

___________________________________________________________ Date: _______ / ________ / ________