Tittle sequence FTV Equipment Booking Form

APPROVED BY TUTOR:
Film & TV Production
APPROVED BY TUTOR:
Equipment Booking Form
USERNAME: billy.dixon
Kit Number:Technical Team
Only
Add in here a complete list of
the Locations with Dates and
indicate Documentation
covered by this booking. Your
Module Tutor will check this
against the documentation
provided on the Crew and
Production Paperwork section.
Collection and return times may be amended by the technical team at the point of handing
paperwork in at the Hatch (this is to be done 48hrs prior to the collection date).
Collection date: 23/03/2015
Return date: 23/03/2015
Location Name:
Date:
Studio one
23/03/2015
Equipment
Camera (Canon 70D)
Camera battery
Tripod
Clapper board & pen
Other Items:
Number
1
2
1
1
Role/s
Crew Member
Name
Billy Dixon
Matthew
McDermott
Liam TaylorRutterford
Producer/Researcher
Camera Operator
(Back Up)
Collection time: 9:00am
Return time: 12:00 am
Issued
Returned
Telephone
RiskA
✔
LocA
✔
Other: (state)
Problems/Faults/Damage
Email
07553063115
07950404546
illy.dixon@yorksj.ac.uk
matthew.mcdermott@yorksj.ac.uk
07964680590
liam.taylor-rutter@yorksj.ac.uk
In order for a booking to be signed off by your Module Tutor and accepted by the Technical Team, all the roles being
undertaken by individual Crew Members must be stated below, including the role booking out the equipment. This is to
ensure that the right Crew Members are collecting the right kit for their shoot. It also provides the Technical Team with
contact details, should there be any issue with the provision of equipment or technical problems with what has been
provided.
Only YSJ email accounts should be used for module work. If you are called by a different name from your email account, put this
in brackets.
I hereby undertake with the Governors of the University of York St John the following:
-
That I am a student of York St John University and Member of the Crew as stated above;
To retain the Equipment in my exclusive possession and control during the period of loan;
To use the equipment only for activities agreed with my Module Tutors and in accordance with the conditions set out below;
That Risk Assessment Forms have been prepared to support the appropriate use of this equipment at the specific times and
locations covered by this booking, and that these have been approved and agreed with my Module Tutors;
I do not foresee any significant hazards other than those noted;
I have carefully considered all the production activities and the findings of the Risk Assessment attached, and further
communicated these findings to the production group and others who may be affected e.g. site owners, engineers,
contractors, freelancers, resources, etc.;
I and other crew members have attended technical demonstrations which provided training in the use of the equipment and
Health & Safety considerations;
- That only trained students or staff of York St John University will be using this equipment (students MUST have relevant stamps
on their production card);
- On being issued, to check that I have received the agreed equipment and that it is in appropriate working order;
- Fair wear and tear accepted. To keep the Equipment in its condition at the date hereof;
- To notify the Technical Team of any faults, problems or damage to the Equipment;
- To indemnify the University in the respect of any loss or damage to
Print Name: Billy Dixon
the Equipment or any part thereof howsoever and by whosoever
caused during the period of loan;
- To return the Equipment to the University forthwith upon demand being
Signature:
made and in the event not later than the return date and time specified
above.
Those responsible for specialist equipment must sign in the appropriate place below to identify themselves as both trained on the
equipment and responsible for appropriate and safe working practices in its use:
-
Equipment
Lighting
JIB
Track
Radio Mics
Other
Role
Name
Signature