This risk assessment form outlines the risks associated with filming the kidnapping scene for a student film. It will involve Kaine Moore being tied to a chair and Nathan Lukeman smashing plates near him on set. The locations will be in Castletown by the river and streets. Potential hazards include being near smashed plates and being tied up. Controls will include keeping Kaine away from smashed plates and using a loose knot that does not stress his wrists when being tied up. With these controls in place, the risks are determined to be slight or negligible.

1. Risk Assessment Form –
Part A
ProductionName: The kidnapping-film Organisation Sunderland college
ProductionAddress: Sunderland, Wessington w ay Producer / Editor
Tel:
Mobile:
Nathan Lukeman
01917 ****
07520 ****
Start date 18th
February End date 20th
February
Distribution
Who gets a copyof the assessment
This w illbe put w ith my pre-production so it w illbe seen by my supervisors
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
There w illbe plates smashed on set near others also there w illbe some physicalaction w ith being tied up on
a chair.
Team members / experts /
contractors / contributors etc.
List those involved
Etan Wilson, Dylan Clark-Rich, Kaine Moore
Locations
Outline locationsinvolved – indicate
any which are hostile environments
Castletow n river, Castletown streets
Assessor Name
Signature
Nathan Lukeman
Nathan
Date completed 17th
February
Authoriser Name
(if not Assessor) Signature
Nathan Lukeman
Nathan
Date authorised 17th
February
Hazard list – select your hazards from the list belowand use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person √ Contact with cold liquid / v apour Disease causativ e agent
Attack by animal Contact with cold surf ace Inf ection
Breathing compressed gas Contact with hot liquid / v apour Allergic reaction
Cold env ironment Contact with hot surf ace Lack of f ood / water
Crush by load Electric shock Lack of oxy gen
Drowning Explosiv e blast Phy sical f atigue
Entanglement in mov ing machinery Explosiv e release of stored pressure Repetitiv e action
High atmospheric pressure Fire Static body posture
Hot env ironment Hazardous substance Stress / anxiety
Manual handling √ Ionizing radiation Venom poisoning
Object f alling, mov ing or f ly ing Laser light
Obstruction / exposed f eature Lightning strike Environmental hazards
Sharp object / material √ Noise Litter
Shot by f irearm Non-ionizing radiation Nuisance noise / v ibration
Slippery surf ace Stroboscopic light Phy sical damage
Trap in mov ing machinery Vibration Waste substance released into air
Trip hazard Waste substance released into soil / water
Vehicle impact / collision Managerial / organisational hazards
Falls f rom height Management f actors (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 likely’ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high

2. Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing: Kaine w illbe tied to a chair for the
physicalpart and I w illbe smashing plates.
Location – w here this activity willtake place: Dates / times:
18th
February
Hazards2
List what could cause harm f rom this activ ity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
f rom this activ ity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
lev el of risk as if y ou were to
do the activ ity without y our
controls
Control measures
For each hazard, list the measures y ou will be taking to minimise the risk identif ied
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide lev el of risk
once all y our controls
are in place
Smashing plates Kaine Moore Moderate, low chance What I w illdo to controlthis is Ill make sure Kaine is a distance aw ayfromthe plate smashing
And w hen he picks a piece of the smashed plate up ill make sure it isn’t sharp enough to cut
himself and that he picks it up on the right end.
Slight, Trivial
Tied up in a chair
Kaine Moore Negligible, Trivial Ill controlthis by making sure the knot isn’t to tight to cause stress on the w rist also willnot
knock him over so he ends up hurting himself.
Negligible, trivial
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