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2. CONTRIBUTORS RELEASE FORM
pRoJEcr ,,rr= Y*rl flyr, n
" (,,the project,,)
DESCRIPTION OF CONTRIBUT!ON
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4r
NAME OF
DATE OF FILMING/CONTRIBUTION
NAME OF CONTRIBUTOR
COMPANY/ORGANISATION RUNNING THE PROJECT
("the Company")
OF CONTRIBUTOR
TELEPHONE NUMBER OF CONTRIBUTOR
Olflq Voaqqq
ln consideration of the Company agreeing that I contribute to and participate in the Project,
the nature and the content of which has been fully explained to me, I hereby consent to the
filming and recording of my contribution to and participation in the Project subject to the
terms and conditions specified below. ^

3. d.L
B.HEALTH AN
THE BBC RISK
D SA F ETY:
ASSESSMENT FORM
EIGIE Generar Risk Assessment Form
- Part A
Aptil 2007- DC
Divi8ion / Studio
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D€partment / Scrics
Busin*a Unit / Producdon
Address
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Producer / Editor
Tel:
Mobile:
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Period covorod by assos3ment )Yul, o )haof Vefsio'l number
Outline of risk assessment
Summary of what is ptopsed
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Team mombsrc / expert6 /
contractora / etc.
Lislthce involved
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Site/Ofiice/Location
Outline sitd l@ations invotued
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Ass€ry Name lgrA+re r lr{r!-t lt 4d
EIE* Date completed
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Authoriser Name
(if not Assssor) Signature
Date authorised
Hazafd lEt - select your hazards frcm the list betow aN u* these to complete Pad B (add others where appopnate)
Situational haards Tick Phy3icsl / chGmlcal hazards Tick Health hazards Tick
Asbestos Contact with @ld liquiJ / vapour Disease €usalive agent
Assault by peEon Contact with @ld surfa@ lnfec{ion
Attecked by animl Contact with hot liquid / vapour Lack ot tood / wter
Bealhing comprcssed gas Contact with hot surface r./ Lack of orygen
Cold envircnmnt Electric shock Physiel falilrue
Crush by load Explosive blast Repetiiive action
Dffiing Explosiv€ El@sg of stocd pressure Static body t
Eniangl€ment in mving machin€ry Firc Strcss
Hot envircnment Haardous aubsian@
lntimidation lonizinE Edialion
Liting Equiprent Laser lighl Envilonmental hazardB
Manusl haodlino Lightning slrike Litter
Otjsct falling, mving orwing Noise Nuisane nobe / vibration
Ob6truc{ion / exposed fealure NoFionizing Ediation Physieldr
Sherp objeci / matedal Strcbos@pic light Vihstc substan@ released into air
Slippery surfa@ VibEtion Vra8te substan@ released inlo soil/ Eier
TEp in mving machinery
Trip haard Other
Vehicle impact / collision
Working at height
RlSk matfiX - ue this to detemine isk lor
eeh ha.ad i.e. 'how bad and how lkey Likellhood of Harm
Sevtrity of Harm
Remoia
e,g, <1 in 1O0O chan@
Unlikely
e.g. 1 in 20O chil@
PGelBible
e.o.1 inficha@
Likely
e.g. 1 in 10 charc
Probable
e.g. >1 in 3 charce
N€gligible e.g. snail brui* Very low Very low Vsry low Low Low
Slight ag ffiail c1tt, deep brui* Very low Vory low Low tedium
iiodcrate e.g. d*p an, lm musb Very low Low Medium Medium
S€Yere e.g. ,?acrurc, lrss ofcfisciosse$ Low
Very SeYtre e.g. death, Fnarenl disabw Low Msdlum
NUJ Commission on multi-media working 2007 53
High
Medlum Hish Hish
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APPENDICES