This risk assessment form summarizes the filming of a music video at Wandlebury in Cambridge, England. Beth Saunders is the director and is responsible for the health and safety of the crew. Two activities are identified: running along a forest pathway and filming near a broken fence. Hazards include tripping over branches on the pathway and falling into the broken fence. Controls include clearing tripping hazards from the pathway and directing filming away from the broken fence. The overall risk level of both activities is assessed as medium after controls are applied.

1. Risk Assessment Form – Part A
Reference:
[enter reference number]]
Sign-off status
Blank Template
[planning/approved etc]
Assessment summary details
Assessment title
(Simple name for
reference purposes)
*
Health and safety form
Production
Division:*
Department:*
Series/ Prod/Unit:
Programme/Area:
Responsible
Manager:
Beth Saunders
Address/Tel:
54 Mill End Road
Contact office:
Address/Tel:
01223 509767
Date assessment
created
18/10/13
Assessment Outline
(Summary of what is
proposed)
Creating and filming a music video
Assessment start
date
Confidential risk
assessment?
Review / End
date
18/10/13
Country location
Cambridge, England
Location details
Wandlebury, Cambridge
Crew / team
(Roles, responsibilities,
competencies)
NO
1/11/13
Hostile / travel
advisory?
NB: If the country location selected is ‘Hostile’ you are
required to: complete the BBC Overseas High Risk
Assessment Form
Beth Saunders-Director
Attachments
(Detail supporting
documents)
Assessor(s)
*
Beth Saunders
Assessor safety
competence
(Person drafting risk
assessment)
Date signed-off *
Authoriser(s) *
(Person responsible for
sign-off)
Distribution
(Who gets a copy of the
assessment)
18/10/13
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
Filming in a Forest
Whole Crew
Fallen branches
Activity Risk Rating
7
Comments log
Who by
Date / time
received
[* mandatory fields]
Comments
Assessor response
Date/ time
responded

2. Risk Assessment Form – Part B
Reference:
6
Sign-off status
[enter reference number]]
ACTIVITIES:
What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).
[planning/approved etc]
HAZARDS & CONTROLS:
How could someone become hurt or made ill and
how are you going to prevent this from happening?
Activity Title:*
Running along a Forest Pathway
Activity Description:
Actor is running along a forest way and is exposed to tripping hazard.
List those managing
this Activity and their
competence:
Beth Saunders- Director
Who & how many are
at risk from this
Activity?
Actor and camera assistant
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
Branches could cause a tripping hazard
I will walk along the walkway with the actor and move any tripping hazards.
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]
Blank Template
Medium

3. Risk Assessment Form – Part B
Reference:
6
Sign-off status
[enter reference number]]
ACTIVITIES:
What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).
Blank Template
[planning/approved etc]
HAZARDS & CONTROLS:
How could someone become hurt or made ill and
how are you going to prevent this from happening?
Activity Title:*
A broken Fence around the filming area
Activity Description:
The actor is in danger of falling and then falling into the broken fence and serious injury.
List those managing
this Activity and their
competence:
Beth Saunders – Low competence
Who & how many are
at risk from this
Activity?
Whole cast and crew
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
Someone could trip and injure themselves on the broken fence
Direct the actor away from the broken fence and walk him along the pathway to check that he dousnt
fall and injure himself
[
]
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]
Medium