This risk assessment form summarizes the activities and potential hazards for filming a music video by Ciarra and Katie. It outlines three activities: filming in a house, filming on the street, and filming in a school dance studio. For each activity, potential hazards are identified such as actors kicking a tripod, cars distracting crew or hitting cast, or a dancer falling and getting hurt. Controls are described to mitigate the risks, such as keeping space clear of the tripod, being aware of surroundings by the road, and ensuring the dancer is prepared. The overall risk levels are assessed as low for filming in the house and dance studio, but medium for filming on the street.

1. Risk Assessment Form – Part A
Reference: None Required Sign-off status Planning
Assessment summary details
Assessment title *
(Simple name for reference
purposes)
Music Video – Ciarra and Katie
Division:* Production Department:* Media
Series/ Prod/Unit: Music Video Programme/Area:
Responsible
Manager:
Katie Edwards
Ciarra Graham
Contact office: Netherhall School and Sixth Form
Centre
Address/Tel: 8 Manor Farm Close
Oakington
CB24 3AT
Queen Ediths way
CB1 8NN
Address/Tel: Queen Ediths Way
CB1 8NN
01223242931
Date assessment created 20/10/2014 Confidential risk
assessment?
NO
Assessment Outline
(Summary of what is
proposed)
Filming of a music video, checking the locations are safe
Assessment start
date
20/10/2014 Review / End date
Country location England Hostile / travel
advisory?
NO
Location details Netherhall School Dance
Studio
Queen Ediths way
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)
Katie Edwards – Director
Ciarra Graham – Camera
Attachments
(Detail supporting
documents)
Assessor(s) *
(Person drafting risk
assessment)
Katie Edwards
Ciarra Graham
Assessor safety
competence
Medium
Authoriser(s) *
(Person responsible for
sign-off)
Mr Day Date signed-off * 21/10/2014
Distribution
(Who gets a copy of the
assessment)
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.
[* mandatory fields]

2. Risk Assessment Form – Part A
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 the house Cast and crew · Actors could kick
the tripod and
damage is as it is
a small space
· Low
Filming on the street Cast and Crew · People walking by
could knock to
tripod and
damage it
· Cars passing
could get
distracted
· Crew and cast
could get hit by a
car
· Low
· Low
· Medium
Filming in the dance studio Cast · Our dancer could
fall and get hurt
· 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: Not required Sign-off status planning
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:* Dancing in a dance studio
Activity Description: Our main female actor will be dancing in the school dance studio
List those managing
this Activity and their
competence:
Kathryn Fisher (dancer) – High competence
Who & how many are
at risk from this
Activity?
1
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
Our dancer could fall and injure herself We will make sure that she is sure about what she is doing and she is prepared for the dancing
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
LOW
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]

4. Risk Assessment Form – Part B Blank Template
6Reference: Not Required Sign-off status planning
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:* Filming on the street
Activity Description: We will be filming a section of the music video on the side of a road
List those managing
this Activity and their
competence:
Katie Edwards - high
Ciarra Graham - high
Who & how many are
at risk from this
Activity?
3 people are at risk (Katie, Ciarra and Kathryn)
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
A car could get distracted by our filming We will make sure we film these parts relatively so we don’t distract mat cars
One of the cast or crew could get hit by a passing car We will make sure we are all aware of our surroundings and that we wont step out near to the road
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
Medium
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]