Proposed Filming - Risk Assessment Form

Premises/ land to be used - Cherry Hinton Chalk Pits

Dates:
6/12/17
9/12/17
3/12/17

Project name: Seraph - Double Blind

Task/Activity Potential Risk How I will

Control and Risk Rating
prevent this risk

Severity Frequency Total

Filming at Crew or cast could the location recce 3 1 4

heights potentially fall and will allow us to
become injured. analyse the safest
spots to film. we
will also use tape
to ensure unsafe
areas are avoided

Use of Smoke The smoke grenades the smoke 1 1 2

Grenades could pose an issue as grenades I plan
they lower visibility, on using are
possibly leading to perfectly safe,
injuries and other risks cold burning
being more likely to occur grenades, and
therefore will not
cause injury. the
cast will be told
how to handle
them safely, and
the shots using
them will not
involve much
movement, so low
visibility will not
be a risk.

Use of sharp someone could get badly Cast will be 2 1 3

props such as injured or cut warned to be
a scalpel careful when
handling such
props, and when
props are not in
use they will be
stored safely with
director
 Task/Activity Potential Risk How I will
Control and Risk Rating
prevent this risk

Severity Frequency Total

Use of fake Could result in an allergic Background 1 1 2

blood reaction if actor has
allergies to ingredients
used in it. could also be
potentially hazardous if
allowed to get into eyes
checks have been
performed on
actors and crew
to ensure that
they do not have
these allergies.
Fake blood will
also be applied
carefully, and
nowhere near the
eyes

frequency
1 = Improbable
2 = Possible
3 = Occasional
4 = Frequent
5 = Regular
6 = Common

Severity
1 = Trivial injuries
2 = Minor injuries
3 = Major injury to one person
4 = Major injuries to several people
5 = Death to one person
6 = several deaths

Proposed Filming in or on privately owned or occupied premises and land

Site Details Cherry Hinton Chalk Pits

Address Fulbourn Road

Cambridge
CB1 9JL

Area of site to be Multiple

used

Date(s) andTime(s) 1) 6/12/17 Start - 12:00 Finish - 5:00

of filming 2) 3/12/17 Start - 12:00 Finish - 3:30
3) 9/12/17 Start - 12:00 Finish - 5:00

Personnel Details
Role First name Last Name Contact Details

Producer Beau Beaumont 12beaubeau@netherhall

.org
Role First name Last Name Contact Details

Site Manager Beau Beaumont 12beaubeau@netherhall

.org

Camera Operator Beau Beaumont 12beaubeau@netherhall

.org

Actor 1 James Rozier jamesrozier@live.co.uk

Actor 2 Ben Fellows ben.gray2608@gmail.co

m

Security Officer Beau Beaumont 12beaubeau@netherhall

.org

Runner Beau Beaumont 12beaubeau@netherhall

.org

Responsible for Beau Beaumont 12beaubeau@netherhall

emergency procedures .org

Stunts/Special effects/ I plan on using coloured smoke grenades, and fake blood
pyrotechnics planned

Special effects Beau Beaumont 12beaubeau@netherhall

coordinator .org