One of the best, strongest facets of American wheelchair football is that there are so many different classifications and adaptations that can be made to make each game as unique as possible.  All aspects of the game, such as rules of play and eligibility, scoring, equipment, and even the field of play can be altered for each match.

The only mandatory requirement for a game of wheelchair football is that all players must be in a wheelchair.  Some leagues will include provisions so individuals who cannot operate a manual or motorized wheelchair can enlist the aid of a designated pusher whose sole job is to propel and maneuver the individual in the chair.  A pusher is not a player and cannot influence the action beyond maneuvering the player.

Examples of other adaptations may include:

•    Field or court of play:  Games must be played on a flat, rectangular surface.  Many leagues utilize a standard-sized basketball court, using lines around the perimeter of the court and beneath the basket to represent boundaries and goal lines, respectively.  Additionally, the basket may be incorporated as a modified field goal post and/or target.
•    Players:  Games can vary tremendously in number of players, based on such factors as number of players in attendance and court size.  Some leagues have rules to accommodate for teams that range from five to 14 players.
•    Chair usage:  Typically, it is required that players remain in their chairs throughout a play, or else they will be disqualified and possibly penalized for the play.
•    Penalties:  Referees may call penalties for a variety of reasons established by a league.  These may include holding and other improper contact, leaving a wheelchair, interfering with a pass, illegal blocking, and other actions that may affect a game.
•    Scoring:  Typically, a touchdown counts as six points, and a field goal counts as three points.  A field goal may vary from throwing a ball between the uprights on top of a basketball goal to hitting the back board of a basketball goal, to name two options.  A point-after-touchdown may always count as one or two points, or may vary based on how it is scored (ex:  one point for rushing it in, two points for throwing it in).
•    Receiving:  Some leagues may require a ball to be physically caught.  Others may allow, based on the physical ability level of a receiver (ex:  an individual with tetraplegia or limb loss), that a ball that hits the receiver in a designated area (chest, back, arm, leg, chair, etc.) counts as a catch, while receivers with more complete use of their hands still have to physically catch a pass.
•    Tackling:  Tackling rules may be very broad as well.  A league may require that a two-hand touch be made to count as a tackle, but modify that rule so that individuals with limb loss or function loss can tackle with one hand.  Some leagues use breakaway or Velcro flag belts, like those used in flag football, attached around the wheelchair that must be removed to count as a tackle.
•    Kicking:  Kickoffs, punts, and field goals are replaced with throws as opposed to kicks.