Risk Assessment Form Brompton Boxing Gym

Risk Assessment Form Part A
Division / Studio
Department / Series
Business Unit / Production
Maidstone Studios,
Producer / Editor
Andrei Allen
Address
Vinters Park,
Tel:
01622-620151
Maidstone,
Mobile:
Kent
ME14 5NZ
Start date
End date
Distribution
Helen Hurston,
Who gets a copy of the assessment

Outline of risk assessment
I will be filming inside of a boxing gym
Summary of what is proposed

Team members / experts / contractors /
contributors etc.
Andrei Allen,
List those involved

Locations
Brompton Amateur Boxing Club Gym
Outline locations involved indicate any which are

hostile environments
Assessor
Name
Date completed
Signature
Authoriser
Name
(if not Assessor)
Signature
Date authorised
Hazard list select your hazards from the list below and use these to complete Part B
Situational hazards
Tick
Assault by person
****
Physical / chemical hazards
Tick
Health hazards
Contact with cold liquid / vapour
Disease causative agent
Attack by animal
Contact with cold surface
Infection
Breathing compressed gas
Contact with hot liquid / vapour
Allergic reaction
Cold environment
Contact with hot surface
Lack of food / water
Crush by load
Electric shock
Lack of oxygen
Drowning
Explosive blast
Physical fatigue
Entanglement in moving machinery
Explosive release of stored pressure
Repetitive action
High atmospheric pressure
Fire
Static body posture
Hot environment
Hazardous substance
Stress / anxiety
Manual handling
Ionizing radiation
Venom poisoning
Object falling, moving or flying
****
Tick
Laser light
Obstruction / exposed feature
Lightning strike
Environmental hazards
Sharp object / material
Noise
Litter
Shot by firearm
Non-ionizing radiation
Nuisance noise / vibration
Slippery surface
****
Stroboscopic light
Physical damage
Trap in moving machinery
****
Vibration
Waste substance released into air
Trip hazard
****
Waste substance released into soil / water
Vehicle impact / collision
Managerial / organisational hazards
Falls from height
Management factors (lack of communication, co-operation, coordination and competence)
Risk matrix use this to determine risk for each hazard i.e. how
Likelihood of Harm
bad and how likely
Remote
Very unlikely
Unlikely
Possible
Likely
e.g. <1 in 1000 chance
e.g. 1 in 200 chance
e.g. 1 in 50 chance
e.g. 1 in 10 chance
e.g. >1 in 3 chance
Negligible e.g. small bruise
Trivial
Trivial
Trivial
Low
Low
Slight e.g. small cut, deep bruise
Trivial
Trivial
Low
Low
Medium
Moderate e.g. deep cut, torn muscle
Trivial
Low
Medium
Medium
High
Severe e.g. fracture, loss of consciousness
Low
Medium
High
High
Extremely high
Very Severe e.g. death, permanent disability
Low
Medium
High
Extremely high
Extremely high
Severity of Harm
Risk Assessment Form Part B

1
Activity Each individual activity you are proposing:
Hazards
List what could cause harm from this activity

e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Location where this activity will take place:
Risk
Control measures
Dates / times:
Risk
For each hazard, decide level of

risk as if you were to do the
activity without your controls
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal
protective equipment, provision of first aid, etc.
For each hazard,

decide level of risk
once all your controls
are in place
Assault by person
Staff
Negligible
This will only happen if I do not watch where Im going, if Im operating within a safe
location letting people know where I am, then I wont get injured
Unlikely
Object falling, moving or flying
Staff
Negligible
This will only happen if I do not watch where Im going, if Im operating within a safe
location letting people know where I am, then I wont get injured
Very unlikely
Trap in moving machinery
Staff
Negligible
If Im not careful watching where im going, I could fall over the bikes or treadmill.
Very unlikely
Slippery surface
Staff
Negligible
Sweat occasionally will fall on the floor, theres also a few leaks around the gym, if I dont
look out for where the hazard cones are then I will slip.
Very unlikely
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

Risk Assessment Form Brompton Boxing Gym

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Risk Assessment Form Part A

Business Unit / Production

Who gets a copy of the assessment

I will be filming inside of a boxing gym

Summary of what is proposed

List those involved

Brompton Amateur Boxing Club Gym

Outline locations involved indicate any which are

(if not Assessor)

Physical / chemical hazards

Contact with cold liquid / vapour

Disease causative agent

Contact with cold surface

Breathing compressed gas

Contact with hot liquid / vapour

Contact with hot surface

Lack of food / water

Entanglement in moving machinery

Explosive release of stored pressure

High atmospheric pressure

Static body posture

Object falling, moving or flying

Obstruction / exposed feature

Sharp object / material

Nuisance noise / vibration

Trap in moving machinery

Waste substance released into air

Waste substance released into soil / water

Vehicle impact / collision

Managerial / organisational hazards

Falls from height

Management factors (lack of communication, co-operation, coordination and competence)

bad and how likely

e.g. <1 in 1000 chance

e.g. 1 in 200 chance

e.g. >1 in 3 chance

Negligible e.g. small bruise

Slight e.g. small cut, deep bruise

Moderate e.g. deep cut, torn muscle

Severe e.g. fracture, loss of consciousness

Very Severe e.g. death, permanent disability

Risk Assessment Form Part B

Activity Each individual activity you are proposing:

List what could cause harm from this activity

Location where this activity will take place:

For each hazard, decide level of

For each hazard,

Object falling, moving or flying

Trap in moving machinery

Continue on separate sheet if necessary

2 - from hazard list in Part A

3 - from risk matrix in Part A

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