This risk assessment form outlines the potential risks for a school ballet performance and filming. It identifies hazards such as twisting ankles while dancing, physical fatigue, repetitive motion, trip hazards, and cold environments. Control measures are proposed to minimize risks, including ensuring safe footwear and flooring, scheduling breaks, choreographing dances in advance, clearing equipment, and allowing time to warm up. The form provides details of the production such as dates, locations at the school and dance studio, and involved parties like the producer, dancers, and family members.

1. Risk Assessment Form – Part A
ProductionName: Starving Organisation St Marys School, Gerrards Cross
ProductionAddress: Producer / Editor
Tel:
Mobile:
Isadora Spratling
Start date 27/01/18 End date 7/02/18?
Distribution
Who gets a copyof the assessment
OCR
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
This risk assessment showsthe possible risks that could occur to my dancer or any other of my actors, in the
w orst-case scenario. This w illhelp myself prepare for any situations w hen filming.
Team members / experts /
contractors / contributors etc.
List those involved
Emily, my mum, tw o dancersand myself
Locations
Outline locationsinvolved – indicate
any which are hostile environments
In and outside the house and in the dance studio.
Assessor Name
Signature
Date completed
Authoriser Name
(if not Assessor) Signature
Date authorised
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 Tick
Crush by load Electric shock Lack of oxy gen
Drowning Explosiv e blast Phy sical f atigue Tick
Entanglement in mov ing machinery Explosiv e release of stored pressure Repetitiv e action Tick
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 Tick Stroboscopic light Phy sical damage
Trap in mov ing machinery Vibration Waste substance released into air
Trip hazard Tick 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
– Ballet class and dance solo atthe end Location – In the dance studio Dates / times:
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
Tw isting ankle w hen dancing
Actor/ dancer Severe
 Making sure that the floor isn’t slippery
 Wearing appropriate footwear.
 Have a first aid box ready to hand
 Regular breaks
Moderate
Physical Fatigue Dancer Negligible
 Making sure I’m organised beforehand so I don’t w aste time
 Build in regular breaks for my dancer into the schedule so she can drink and eat
Negligible
Repetitive action
Dancer Slight  Choreograph the dance before the filming day so I know w hich shots Ineed.
 Using my storyboard and stickto it
 To make the dace sometimes w hen practising to safe her energy.
Negligible
Trip hazards Dancer and actors Slight  To make sure the rooms and the studio is completely clear of all clutter and filming
equipment before starting
Negligible
Cold environment Dancer and actors Slight  Before w e start the studio is often cold. I w illmake sure to arrive early and put the
heating on
 Make sure the actors and dancers have lots of layers on and out them on betw een
takes
Negligible
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