![Risk Assessment Form – Part A Blank Template
Reference: Sign-off status
Assessment summary details
Assessment title *
(Simple name for reference
purposes)
Lazarus Risk Assessment
Division:* Film Production Department:* Drama
Series/ Prod/Unit: Horror/Mystery Programme/Area: Lazarus
Responsible
Manager:
Anne Diangson / Reece
Howard
Contact office: -
Address/Tel: - Address/Tel: -
Date assessment created - Confidential risk
assessment?
-
Assessment Outline
(Summary of what is
proposed)
Filming in the Atrium Hall using the stage and creating a storage room using tables.
Ladders and considerable height with risk of falling. A wide selection of props and
equipment used and there is risk of tripping over. Risk of other people in the school as
they are unaware as to what is going on.
Assessment start
date
- Review / End date -
Country location England Hostile / travel
advisory?
-
Location details The Netherhall School and Sixth
Form Centre is a secondary
school and sixth form in the
Queen Edith ward of
Cambridge, England. Its logo is
the crest of Cambridge. It is one
of the largest schools in the
area in terms of capacity.
NB: If the country location selected is ‘Hostile’ you are
required to: complete the BBC Overseas High Risk
Assessment Form
Crew / team
(Roles, responsibilities,
competencies)
Anne Diangson and Reece Howard – Camera and Film Director, Responsible for props and camera
equipment
Sophie Butler – Actor, Act according to directors instructions
Attachments
(Detail supporting
documents)
Atrium Hall
Assessor(s) *
(Person drafting risk
assessment)
Anne Diangson Assessor safety
competence
[* mandatory fields]](https://image.slidesharecdn.com/netherhall-risk-assessment-form-141123142422-conversion-gate02/85/Lazarus-Risk-Assessment-1-320.jpg)
![Risk Assessment Form – Part A Blank Template
Authoriser(s) *
(Person responsible for
sign-off)
Brendan Sheppard Date signed-off *
Distribution
(Who gets a copy of the
assessment)
Brendan Sheppard, Reece Howard, Netherhall School
Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and
those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and
legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including
our agents and contractors, with whom the risk or the control of risk is shared.
Activity and Hazard Summary [This is a summary of the activities listed in part B of the risk assessment.]
Activity Who Exposed Hazards{hazard titles Activity Risk Rating
Filming in atrium Directors and actors Falling, tripping Medium
Comments log
Who by Date / time
received
Comments Assessor response Date/ time
responded
[* mandatory fields]](https://image.slidesharecdn.com/netherhall-risk-assessment-form-141123142422-conversion-gate02/85/Lazarus-Risk-Assessment-2-320.jpg)
![Risk Assessment Form – Part B Blank Template
6Reference: Sign-off status
ACTIVITIES: What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).
HAZARDS & CONTROLS: How could someone become hurt or made ill and
how are you going to prevent this from happening?
Activity Title:* Standing on stage in front of an audience
Activity Description: The actor will be standing on stage in front of a fake audience
List those managing
this Activity and their
competence:
Reece Howard – High Competence
Anne Diangson – High Competence
Who & how many are
at risk from this
Activity?
Reece, Anne and Sophie – also any students in the hall
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
Crew and actor could fall of the stage, while misjudging the
location
Ensure that crews and actors are far away from the edge of the stage at all times. This way, they will all
be safely in the center of the stage and no possibility of falling at the edge
Crew and actor could trip over equipment and props, resulting in
a damage of equipment
Make sure that there is always someone in charge of specific equipment so that they can warn if anyone
is in danger. If there is no one available to be in charge, it would be useful to put a sign.
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
Medium
[* mandatory fields]](https://image.slidesharecdn.com/netherhall-risk-assessment-form-141123142422-conversion-gate02/85/Lazarus-Risk-Assessment-3-320.jpg)
Lazarus Risk Assessment
- 1. Risk Assessment Form – Part A Blank Template Reference: Sign-off status Assessment summary details Assessment title * (Simple name for reference purposes) Lazarus Risk Assessment Division:* Film Production Department:* Drama Series/ Prod/Unit: Horror/Mystery Programme/Area: Lazarus Responsible Manager: Anne Diangson / Reece Howard Contact office: - Address/Tel: - Address/Tel: - Date assessment created - Confidential risk assessment? - Assessment Outline (Summary of what is proposed) Filming in the Atrium Hall using the stage and creating a storage room using tables. Ladders and considerable height with risk of falling. A wide selection of props and equipment used and there is risk of tripping over. Risk of other people in the school as they are unaware as to what is going on. Assessment start date - Review / End date - Country location England Hostile / travel advisory? - Location details The Netherhall School and Sixth Form Centre is a secondary school and sixth form in the Queen Edith ward of Cambridge, England. Its logo is the crest of Cambridge. It is one of the largest schools in the area in terms of capacity. NB: If the country location selected is ‘Hostile’ you are required to: complete the BBC Overseas High Risk Assessment Form Crew / team (Roles, responsibilities, competencies) Anne Diangson and Reece Howard – Camera and Film Director, Responsible for props and camera equipment Sophie Butler – Actor, Act according to directors instructions Attachments (Detail supporting documents) Atrium Hall Assessor(s) * (Person drafting risk assessment) Anne Diangson Assessor safety competence [* mandatory fields]
- 2. Risk Assessment Form – Part A Blank Template Authoriser(s) * (Person responsible for sign-off) Brendan Sheppard Date signed-off * Distribution (Who gets a copy of the assessment) Brendan Sheppard, Reece Howard, Netherhall School Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including our agents and contractors, with whom the risk or the control of risk is shared. Activity and Hazard Summary [This is a summary of the activities listed in part B of the risk assessment.] Activity Who Exposed Hazards{hazard titles Activity Risk Rating Filming in atrium Directors and actors Falling, tripping Medium Comments log Who by Date / time received Comments Assessor response Date/ time responded [* mandatory fields]
- 3. Risk Assessment Form – Part B Blank Template 6Reference: Sign-off status ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below). HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening? Activity Title:* Standing on stage in front of an audience Activity Description: The actor will be standing on stage in front of a fake audience List those managing this Activity and their competence: Reece Howard – High Competence Anne Diangson – High Competence Who & how many are at risk from this Activity? Reece, Anne and Sophie – also any students in the hall Hazards How could someone become hurt or made ill Control measures How are you going to prevent this from happening? Crew and actor could fall of the stage, while misjudging the location Ensure that crews and actors are far away from the edge of the stage at all times. This way, they will all be safely in the center of the stage and no possibility of falling at the edge Crew and actor could trip over equipment and props, resulting in a damage of equipment Make sure that there is always someone in charge of specific equipment so that they can warn if anyone is in danger. If there is no one available to be in charge, it would be useful to put a sign. Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Medium [* mandatory fields]