This risk assessment form covers the filming of a music video to be shot on Boscombe Pier and beach from November 27th to December 6th. It lists the producer, crew, and locations involved. Potential hazards are identified from situations like drowning, falls, allergic reactions, stress, and litter. For each hazard, control measures are outlined such as appointing a first aid trained crew member, using barriers to prevent falls, notifying of allergies, scheduling breaks to reduce stress, and cleaning the area. With these controls, the post-control risk level is deemed low to trivial for all identified hazards.

1. Risk Assessment Form – Part A
ProductionName: Skyscraper Organisation N/A
ProductionAddress: Magna Academy Poole,
Ashdown Close, Poole, Dorset.
BH17 8RE
Producer / Editor
Tel:
Mobile:
Bethany Stacey
/
07921***181
Start date 27th
November 2015 End date 6th
December 2015
Distribution
Who gets a copyof the assessment
Bethany Stacey, Andrew Stacey, Alex Warren, Ben Hartw ell- Benison.
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
A music video based on a break up. Will be filmed mainly on Boscombe Pier but w illinclude the surrounding
areas such as the beach too. Will be filmed around 80% on the pier, but w illinclude flashbacks on the beach
too.
Team members / experts /
contractors / contributors etc.
List those involved
Bethany Stacey, Andrew Stacey, Alex Warren, Ben Hartw ell- Benison.
Locations
Outline locationsinvolved – indicate
any which are hostile environments
Boscombe Pier
Boscombe Beach
Small Café
Assessor Name
Signature
Bethany Stacey Date completed 20th November 2015
Authoriser Name
(if not Assessor) Signature
Date authorised 21st
November 2015
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 X Contact with cold liquid / v apour Disease causativ e agent
Attack by animal X Contact with cold surf ace Inf ection X
Breathing compressed gas Contact with hot liquid / v apour Allergic reaction X
Cold env ironment X Contact with hot surf ace Lack of f ood / water
Crush by load Electric shock Lack of oxy gen
Drowning X Explosiv e blast Phy sical f atigue X
Entanglement in mov ing machinery Explosiv e release of stored pressure Repetitiv e action X
High atmospheric pressure Fire X Static body posture
Hot env ironment Hazardous substance Stress / anxiety X
Manual handling Ionizing radiation Venom poisoning
Object f alling, mov ing or f ly ing X Laser light
Obstruction / exposed f eature X Lightning strike Environmental hazards
Sharp object / material X Noise X Litter X
Shot by f irearm Non-ionizing radiation Nuisance noise / v ibration X
Slippery surf ace X Stroboscopic light Phy sical damage X
Trap in mov ing machinery Vibration Waste substance released into air
Trip hazard X Waste substance released into soil / water
Vehicle impact / collision X Managerial / organisational hazards
Falls f rom height X 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 Low Medium High High
Slight e.g. small cut, deep bruise Medium Low Medium High Medium
Moderate e.g. deep cut, torn muscle Low Medium Medium Medium Low
Severe e.g. fracture, loss of consciousness Low Low Low Low Trivial
Very Severe e.g. death, permanent disability Trivial Trivial Trivial Trivial Trivial

2. Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing:
Activity of filming on the pier.
Location – w here this activity willtake place: Boscombe Pier, Boscombe Beach ,Small Café 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
Drow ning Staff, contributors and
the public. Medium
Issuing training in case of this event, on sight first aider, equipment on sight in case of this
event i.e. floatation device. Low
Falls from height Staff, contributors and
the public.
Medium On sight first aider, preventions such as barriers, training to avoid situations that could lead to
falling.
Low
Allergic reaction Staff, contributors and
the public.
Low On sight first aider, all crew willbe notified about any allergies, allergic reaction training
issued no contact w ith the allergen.
Trivial
Stress / anxiety Staff, contributors and
the public.
Medium Severalbreaks, minimal stress levels. Low
Litter Staff, contributors and
the public.
High Make sure the area is cleaned, no staff/ crew drops litter. Medium
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