The annual NAOAGA championship is held in different regions of the North American Continent and is structured in the traditional manner in which golf was founded.

The match play format was selected to determine the annual champion in two divisions: assisted, where golfers are allowed to utilize prosthetic devices and/or touch the club with two limbs; unassisted, where golfers touch the club with only one arm.

The first day of play is stroke play, which determines the low eight qualifiers in each division. The qualifiers then proceed to the match play competition. Non-qualifiers participate in a series of alternate shot and best ball events throughout the tournament, playing for prizes.