Activity

Risk Assessment Form Part A

Division / StudioDepartment / Series

Business Unit / Production

AddressMaidstone Studios,

Vinters Park,

Maidstone,

Kent

ME14 5NZProducer / Editor

Tel:

Mobile:Andrei Allen

01622-620151

Start date13-01-2015End date17-01-2015

Distribution

Who gets a copy of the assessmentHelen Hurston,

Outline of risk assessment

Summary of what is proposedI will be filming inside of a boxing gym

Team members / experts / contractors / contributors etc.

List those involved Andrei Allen,

Locations

Outline locations involved indicate any which are hostile environmentsBox2win professional boxing club

Assessor Name

SignatureAndrei AllenDate completed13-01-2015

Authoriser Name

(if not Assessor)SignatureAndrei AllenDate authorised13-01-2015

Hazard list select your hazards from the list below and use these to complete Part B

Situational hazardsTickPhysical / chemical hazardsTickHealth hazardsTick

Assault by person****Contact with cold liquid / vapourDisease causative agent

Attack by animalContact with cold surfaceInfection

Breathing compressed gasContact with hot liquid / vapourAllergic reaction

Cold environmentContact with hot surfaceLack of food / water

Crush by loadElectric shockLack of oxygen

DrowningExplosive blastPhysical fatigue

Entanglement in moving machineryExplosive release of stored pressureRepetitive action

High atmospheric pressureFireStatic body posture

Hot environmentHazardous substanceStress / anxiety

Manual handlingIonizing radiationVenom poisoning

Object falling, moving or flying****Laser light

Obstruction / exposed featureLightning strikeEnvironmental hazards

Sharp object / materialNoiseLitter

Shot by firearmNon-ionizing radiationNuisance noise / vibration

Slippery surface****Stroboscopic lightPhysical damage

Trap in moving machinery****VibrationWaste substance released into air

Trip hazard****Waste substance released into soil / water

Vehicle impact / collisionManagerial / organisational hazards

Falls from heightManagement factors (lack of communication, co-operation, co-ordination and competence)

Risk matrix use this to determine risk for each hazard i.e. how bad and how likelyLikelihood of Harm

Severity of HarmRemote

e.g. 1 in 3 chance

Negligible e.g. small bruiseTrivialTrivialTrivialLowLow

Slight e.g. small cut, deep bruiseTrivialTrivialLowLowMedium

Moderate e.g. deep cut, torn muscleTrivialLowMediumMediumHigh

Severe e.g. fracture, loss of consciousnessLowMediumHighHighExtremely high

Very Severe e.g. death, permanent disabilityLowMediumHighExtremely highExtremely high

Risk Assessment Form Part B

Activity1 Each individual activity you are proposing:

Filming Boxers Sparring

Filming Boxers doing pad work up close

Filming boxers doing bag work up close

Filming boxers shadow boxingLocation where this activity will take place: Inside the Boxing GymDates / times:17-01-2015 - 13-01-201517:00pm - 18:30pm

Hazards2

List what could cause harm from this activity

e.g. falls from height, trip hazard, fire, etc.Who exposed

List who might be harmed from this activity

e.g. staff, contractors, contributors, public, etc.Risk3For each hazard, decide level of risk as if you were to do the activity without your controlsControl measures

For each hazard, list the measures you will be taking to minimise the risk identified

e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc.Risk3For each hazard, decide level of risk once all your controls are in place

Assault by personStaffNegligibleThis will only happen if I do not watch where Im going, if Im operating within a safe location letting people know where I am, then I wont get injuredUnlikely

Object falling, moving or flyingStaffNegligibleThis will only happen if I do not watch where Im going, if Im operating within a safe location letting people know where I am, then I wont get injuredVery unlikely

Trap in moving machinery

StaffNegligibleIf Im not careful watching where Im going, I could fall over the weights or the leg press machine.Very unlikely

Slippery surfaceStaffNegligibleSweat occasionally will fall on the floor.Very unlikely

Continue on separate sheet if necessary

1 complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A