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Stunt Questionnaire
In order to properly evaluate the hazards involving stunts used in filming, please provide the information requested below. Additional information may be requested upon receipt and review of below.
Name:
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Email Address:
*
Type of Scenes Being Filmed:
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List of Stunts by Type, Location*, and Date (*exact street address, please)
*
Protective Measures Used to Protect Participants and Public:
*
Who is Employer of Record of Persons Performing Stunts:
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How Many People Involved in Stunt Scenes? Number of Takes?
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Experience of Stunt People in Performing Similar Stunts? Any Injuries or Losses Resulting from Performing Similar Stunts? If Yes, Please Give Specifics.
*
This is important! Please read!
In order to minimize any stunt of hazardous surcharges and keep your premiums at a minimum, PLEASE provide us with FULL information so that we can do a better job for you and the production company.