Starting a sport safely: costs, physicals, concussion and heat rules

The short answer

Pick for fit, not prestige. Choose a sport you enjoy, can afford and can get to. For children, a mix of sports and an off season help prevent overuse injuries.
Budget the whole season. In a late-2024 national survey, families spent an average of $1,016 a year on a child's main sport, 46% more than five years earlier.
Get a physical, and report warning signs. Fainting, chest pain, a racing heartbeat or unusual breathlessness during exercise need a clinician's check before play.
In California, a suspected concussion means out for the day. A young athlete needs written clearance from a licensed health care provider to return, and a diagnosed concussion means a return-to-play protocol of at least 7 days, in schools and community youth sports alike.
Respect the heat. Build up slowly and drink water before you feel thirsty. Stumbling, collapse or a change in behavior in the heat is an emergency: call 911 and start cooling the person.
Read before you sign. Check your health plan's network before the season, ask what insurance the league carries, and keep a copy of any waiver.

Choosing a sport

The best sport is the one you will keep doing. Before you look at schedules, answer a few plain questions:

Team or solo? Teams bring a fixed schedule and friends. Solo sports, such as swimming or running, fit around work and school more easily.
How much contact? Sports range from none (swimming, golf) to regular collisions (football). More contact usually means more protective gear and different injuries to plan for.
Where and when? A nearby league is easier to stick with than a better team an hour away.
Does it fit your health? With a heart, lung, joint or blood sugar condition, plan the sport with your clinician.

For adults

Many adults come back to sport through a community recreation class, a drop-in session or an adult league; pickleball is a popular low-impact start. MedlinePlus, the National Library of Medicine's health site, lists low fitness, poor training practices, the wrong gear and skipping warm-ups among the common causes of sports injuries. A few weeks of regular walking and basic strength training before your first season gives your body a base to build on.

For children and teens

In a 2021 MedlinePlus Magazine article, a sports medicine surgeon gave parents four tips: have an off season so bones and joints can recover, follow the safety rules, play a variety of sports rather than specializing early, and track repetitive motion, such as Little League pitch counts, across every team a child plays on. The Aspen Institute's Project Play parent survey found travel teams and private lessons are starting at younger ages, though they remain a minority experience for most children.

Way to play	Ask before you join
City or community recreation league	Practice nights, total fees, and whether coaches have had concussion and cardiac training
School team (high schools follow California Interscholastic Federation, or CIF, rules)	Which forms and physical are due, and by when
Club or travel team	The full-year cost including travel, and how many months off
Classes, drop-in sessions and adult leagues	Skill level, equipment rental and the waiver you will sign
Adaptive and inclusive programs	See the adaptive sports section below

What it really costs

Youth sports cost more than many families expect. In the Aspen Institute's National Youth Sports Parent Survey of 1,848 parents, run in November and December 2024 with Utah State University and Louisiana Tech University:

Families spent an average of $1,016 on a child's primary sport in 2024, up 46% from 2019, about twice the rate of inflation.
They spent an average of $475 more on other sports teams the child played.
Over five years, spending rose 105% for basketball, 69% for soccer and 68% for baseball.
Across all sports, urban families spent $1,628 per child, suburban families $1,552 and rural families $924.
Higher spending on travel, registration, equipment, private lessons and camps drove the increase.

The same cost items apply to adult leagues. Use this list before you commit:

Cost item	Ask before you commit
Registration or season fee	What does it include: uniform, field fees, insurance, referees? Are there sibling discounts, payment plans or fee waivers?
Uniform and required gear	Which items must be new, and which can be borrowed, used or rented?
Protective gear	What does the rule book require: helmet, mouthguard, eye protection, shin guards? Ask the coach before buying used protective gear.
Lessons, coaching and camps	Are they optional, or expected for playing time?
Travel and tournaments	How many away events, how far, and how many overnight stays?
Medical costs	Is a physical required? What are your plan's copays for a sports visit or an injury?

Accessibility and adaptive sports

People with disabilities play almost every sport, sometimes with changed rules or equipment, sometimes in programs built for them.

At school

Under Section 504 of the federal Rehabilitation Act, public schools must give students with disabilities an equal opportunity to take part in extracurricular athletics. The U.S. Department of Education's Office for Civil Rights explained this in a January 25, 2013 letter and fact sheet, still listed as policy guidance on the Department's equal access page (last reviewed September 23, 2025). Under that guidance, a school:

may not exclude a student based on stereotypes about a disability;
must look at the individual student and decide whether reasonable changes or aids would allow the student to take part, such as a light with the starter pistol for a deaf runner;
does not have to change an essential part of the game, give an unfair advantage, or compromise safety;
is encouraged, but not required, to offer separate athletic programs when a student cannot take part in existing ones even with changes.

If a school has not met these duties, start with its Section 504 coordinator, then contact the Office for Civil Rights.

In the community

A 2022 adaptive sports guide from the Christopher & Dana Reeve Foundation, supported by the federal Administration for Community Living, points to these starting places:

Move United, a nonprofit founded in 1956, with a national network of more than 200 community adaptive sports groups and a search tool for local programs.
Paralympic sport. The U.S. Olympic & Paralympic Committee lists coaches, clubs and events, and sport organizations such as USA Boccia list local clubs.
Veterans can ask their local VA hospital about the Department of Veterans Affairs' year-round adaptive sports events.
Equipment. Most adaptive programs supply it. The Challenged Athletes Foundation offers equipment grants to anyone with a permanent physical disability, and state assistive technology centers may run loan closets.

The pickleball guide covers playing with a wheelchair or a mobility disability.

Sports physicals

A sports physical, or pre-participation exam, checks for health problems that could make a sport unsafe. It reviews your history and includes a focused exam of the heart, lungs, joints and other systems. MedlinePlus lists getting a physical as the first step before starting a sport. What to expect at the visit is covered in the site's guide to sports physicals and pre-participation exams.

Get the form first. Your school, league or club decides whether a physical is required and which form to use.
Gather your history: medicines, past injuries and concussions, surgeries, and heart problems or sudden deaths in close relatives.
Book early, bring the form, and keep a copy once it is signed.

Warning signs to tell the clinician about. The California Department of Education's sudden cardiac arrest information form calls sudden cardiac arrest the leading cause of death in student athletes during exercise, and notes that many young people with heart conditions have warning signs but do not tell an adult. It lists:

fainting or a seizure, especially during or right after exercise;
fainting more than once, or with excitement or being startled;
unusual shortness of breath during exercise;
a racing or fluttering heartbeat, or an irregular heartbeat;
repeated dizziness or light-headedness;
chest pain or discomfort with exercise;
extreme, unexpected tiredness during or after exercise.

What it costs. Covered California says most plans cover preventive care, including yearly checkups, at no cost, and that care outside your plan's network can mean paying the full price. A stand-alone sports physical may be billed differently, so ask whether the sports form can be completed at your child's yearly checkup, and ask the price of any separate visit.

Adults. An adult league may not ask for a physical. If you have heart symptoms or heart disease, high blood pressure, diabetes, asthma, recent surgery or osteoporosis, talk with your clinician first; see the strength training guide's checklist of reasons to check first and understanding asthma.

Concussion rules for youth sports in California

A concussion is a type of brain injury. California has two state laws on concussion in youth sports, and the CIF adds its own rule for high schools. All three point the same way: when in doubt, the athlete sits out until a licensed health care provider says otherwise, in writing.

Setting	Rule	What it requires
Public, charter and private schools that offer athletics	Education Code section 49475	Removal for the rest of the day if a concussion or head injury is suspected. Return only with written clearance from a licensed health care provider trained in concussion. If a concussion is diagnosed, a graduated return-to-play protocol of at least 7 days under a licensed provider's supervision. An information sheet signed every year by athlete and parent. Does not cover regular physical education classes.
High schools in the CIF	CIF Bylaw 503.H	Immediate removal for signs or symptoms. Return only with written clearance from a licensed health care provider trained in concussion. Coaches, paid or volunteer, should be trained before the first practice; California law requires concussion training for coaches, and a free 20-minute online course from the National Federation of State High School Associations (NFHS) and CIF meets it.
Community youth sports: any organization, business, nonprofit or local agency running competitions, training, camps or clubs for people 17 or younger	Health and Safety Code section 124235	Removal for the rest of the day for a suspected concussion or head injury, or for fainting. Written clearance from a licensed health care provider. At least 7 days of graduated return to play if a concussion is diagnosed. Parent told of the time, date, symptoms and treatment. Concussion and cardiac information sheets signed every year. Coaches, administrators and referees complete training at least once before supervising athletes.

If you suspect a concussion

Take the athlete out right away for the rest of the day, even if they feel fine.
Watch for danger signs (below). If any appear, call 911.
Tell the parent or guardian. Community youth programs must notify them.
See a licensed health care provider trained in concussion, and ask for written clearance or a written plan.
Follow the step-by-step return, at least 7 days if a concussion is diagnosed. The stages are in the site's concussion and return-to-play guidance.
Give the coach a copy of the clearance, and keep one.

Get help now: head injury

Get emergency care right away if, after a head injury, the person becomes very sleepy, behaves abnormally or makes no sense when speaking, develops a severe headache or stiff neck, has a seizure, has pupils of different sizes, cannot move an arm or leg, loses consciousness even briefly, or vomits more than once. Call 911 for severe bleeding from the head or face, confusion or unconsciousness, stopped breathing, or a suspected head or neck injury. Do not move the person unless you must, do not shake them, and do not remove a helmet if you suspect a serious head injury. Source: MedlinePlus, Head injury: first aid.

Sudden cardiac arrest and emergency plans

California law tells schools and youth programs what to do when an athlete faints, and when emergency equipment must be on hand.

Schools. Under the Eric Paredes Sudden Cardiac Arrest Prevention Act (AB 1639), in effect since July 1, 2017, a student and a parent sign a sudden cardiac arrest acknowledgment every school year before the student takes part in athletics. A student who faints during or after athletic activity is removed from play and cannot return until a physician, nurse practitioner or physician assistant has evaluated and cleared them.
Community youth sports. The same youth sports law that covers concussion requires removal for fainting. If a provider suspects a heart condition, the athlete stays under that provider's care for follow-up testing until cleared. The yearly information sheet must cover the emergency response: call 911, give hands-only CPR, and use an automated external defibrillator (AED) if one is available.
School emergency plans. A school district or charter school with interscholastic athletics must have a written emergency action plan covering where emergency equipment is kept and what to do for sudden cardiac arrest, concussion and heat illness, including, since July 1, 2024, how often staff rehearse it.

New for community youth sports: the Nevaeh Youth Sports Safety Act. AB 310 (Chapter 254, Statutes of 2025, signed October 3, 2025) applies to youth sports organizations that offer an athletic program:

Starting	Requirement
January 1, 2027	Coaches certified in CPR and AED use, renewed at least every 2 years. A written cardiac emergency response plan, reviewed every year with coaches and staff, covering where AEDs are, who does what, and a yearly electronic notice to parents.
January 1, 2028	Athletes have access to an AED during official practices and matches. AEDs are maintained and tested according to the manufacturer's instructions.

Ask your league now how it will meet these dates, where the nearest AED is at your field, and who is trained to use it.

Heat, hydration and air quality

California's Education Code counts heat cramps, fainting from heat, heat exhaustion and exertional heat stroke as heat illness, according to the Senate Education Committee. The Centers for Disease Control and Prevention (CDC) gives athletes and coaches these heat safety steps:

Drink more water than usual, and do not wait until you are thirsty.
Wear loose, lightweight, light-colored clothing and sunscreen.
Practice early or late in the day, not at midday.
Start slowly and increase intensity gradually.
Watch a teammate, and ask someone to watch you.
Treat muscle cramps as an early warning. If you feel faint or weak, stop, move to a cool place and get medical care.

The NFHS sports medicine committee's October 2025 heat position statement adds that early-season practices should be shorter and easier, protective gear should be added over several days, and athletes should arrive hydrated, with pale, straw-colored urine. Energy drinks are not a hydration fluid.

Get help now: heat

Clumsiness, stumbling, collapse or a change in behavior during exercise in the heat are serious warning signs. Stop the activity, call 911 and start rapid cooling on site, for example in a tub of ice water or with an ice-water tarp. The NFHS principle is "cool first, transport later." Source: NFHS heat position statement, 2025.

CIF heat and air quality rules

CIF high schools follow the heat and air quality policy in the 2026-27 CIF Constitution and Bylaws (Bylaws 503.K and 503.L), which CIF says follows California's AB 1653. It uses the wet bulb globe temperature (WBGT), a heat-stress reading taken with a special meter rather than the ordinary air temperature. Practices and games must be cancelled or delayed until cooler when the reading goes above the limit for the school's region category:

Region category	Cancel or delay above
Category 1	86.2°F
Category 2	89.9°F
Category 3	92.0°F

Schools find their category on a CIF map. EdSource reports that desert areas and the Central Valley are in the hottest category.
Schools without a WBGT meter may use a National Oceanic and Atmospheric Administration (NOAA) reading.
Every practice and game site must have a whole-body cooling method close at hand, such as an ice tub, a "taco" tarp or ice towels.
In fall football, players wear helmets only for the first 3 days, add shoulder pads on days 4 and 5, and wear full pads from day 6.
For air quality, schools check the Air Quality Index (AQI) on AirNow. Above 100, they should consider removing athletes with lung or heart conditions; above 150, they should seriously consider rescheduling or moving indoors.

What changed in 2026. AB 2503, signed in 2026, requires the CIF to review its heat guidelines by July 1, 2027 and every year after, with special attention to hotter regions (Senate Education Committee analysis; EdSource). The law itself does not set a new temperature limit, as Healthy Roster notes.

Club and adult leagues are not bound by CIF rules. Ask what heat and smoke policy they use. Some medicines raise heat risk; see medications that raise heat risk and heat-related illness in the Central Valley.

Warm-up and injury prevention

MedlinePlus advises building up your fitness, using proper training methods and equipment, and warming up before activity. Its sports safety page adds the right shoes and gear and plenty of water. A safer first month looks like this:

Build a base before the first practice. Walk, and add simple strength work for the legs, hips and core.
Get gear that fits, including everything the rule book requires.
Warm up before and cool down after every practice and game.
Increase time and effort gradually, especially in hot weather.
Take rest days, and for children, an off season.
Stop when you get hurt. MedlinePlus warns that continuing to play can cause more harm.
Come back slowly. Recover fully first, protect the area with padding or a brace if advised, and start slowly when you return.

Growing athletes get some overuse problems adults do not. One is Osgood-Schlatter disease, painful swelling of the bump just below the knee. MedlinePlus says it affects teens during growth spurts, especially in soccer, basketball, volleyball and gymnastics, and almost always settles once growth stops, though some children need to stop most sports for 2 months or more. Contact your child's clinician for knee or leg pain, or pain that does not improve.

For sport-specific advice, see pickleball for beginners: rules and injury prevention.

When to see a clinician

Call 911

Call 911 if an athlete collapses and does not respond: start hands-only CPR and send someone for an AED. Also call 911 for the head injury and heat danger signs above, or for a suspected broken bone in the head, neck, back, hip, pelvis or upper leg; a bone through the skin; severe bleeding; or skin below an injured joint that is pale, cold, clammy or blue. Sources: Health and Safety Code section 124235; MedlinePlus, Broken bone.

See a clinician before playing again for:

any suspected concussion. California law requires written clearance for young athletes;
fainting during or after exercise. Students need clearance from a physician, nurse practitioner or physician assistant;
chest pain, a racing or irregular heartbeat, unusual breathlessness or extreme tiredness with exercise;
signs of a possible broken bone: a limb that looks out of place, swelling or bruising, severe pain, numbness or tingling, or not being able to move a limb or put weight on a leg;
a child's knee or leg pain, or any pain that is not improving;
feeling faint or weak in the heat.

Treatment of a sports injury often starts with rest, ice, compression and elevation (RICE), according to MedlinePlus. Because children's bones are still growing, a sports medicine surgeon quoted in MedlinePlus Magazine advises care from clinicians experienced with young athletes. Your primary care clinician can examine an injury and refer you on. If you are unsure how fast to act, see when a symptom needs urgent or emergency care.

Insurance and waivers

Who pays if you get hurt

Before the season, look up your health plan's network, copays and deductible, so you know where to go for an injury. Covered California warns that care outside your network can mean paying the full cost. Then ask the league:

Does it carry accident insurance for players? What does it cover, and does it pay only after your own plan pays?
What medical information and emergency contacts does it keep, and who at the field is trained in first aid, CPR and AED use?

If your health plan denies care. For plans regulated by the California Department of Managed Health Care (DMHC), first file a grievance with your plan and take part in its process for 30 days. You do not have to wait if your case involves a serious threat to your life. If the problem is not fixed, ask the DMHC Help Center for an Independent Medical Review or file a complaint, online or at 1-888-466-2219. The DMHC says complaints generally take about 30 days and reviews about 45 days. If the DMHC does not license your plan, it will refer you to the right agency.

Waivers: what you are signing

A waiver, or release, is a contract you sign before you play that gives up some of your right to sue the program if you are hurt.

In City of Santa Barbara v. Superior Court (July 16, 2007), the California Supreme Court held that a sports or recreation release that tries to excuse future gross negligence is generally unenforceable as a matter of public policy. The court described gross negligence as "either a want of even scant care or an extreme departure from the ordinary standard of conduct." The case involved a 14-year-old with developmental disabilities who drowned at a city summer camp after her mother signed a release. The court did not decide whether that release covered ordinary carelessness.

Read it before you sign, and keep a dated copy.
Notice what else is in it, such as photo releases, medical consent or payment terms.
After a serious injury, talk with a licensed California attorney. This guide is not legal advice.

Questions readers ask

Can a coach decide alone that a player with a head injury is fine? Not in California schools or community youth sports. Once a concussion is suspected, the athlete is out for the day and needs written clearance from a licensed health care provider before returning.

Do the concussion laws cover my adult league? The state laws are written for schools and for organizations whose programs include athletes 17 or younger. An adults-only league may set its own rules, so ask. The danger signs for a head injury apply at any age.

Is a travel team worth it for a young child? That is a family choice. The national survey found travel teams are still a minority experience, and the sports medicine advice above favors variety and an off season for growing athletes.

Also on this site: pickleball for beginners: rules, the court and injury prevention; sports physicals and pre-participation exams; concussion and return-to-play guidance for young athletes; strength training for beginners; how to start a walking routine; and your first day hike checklist.

Where to get free help

Emergencies: call 911.
Your school's athletic director, or your CIF section. The CIF has ten regional sections. Its concussion resources page has information sheets for students and parents in English and Spanish.
California Department of Education: the sudden cardiac arrest information form used by schools.
U.S. Department of Education, Office for Civil Rights: disability access in school sports. See its equal access page.
DMHC Help Center: 1-888-466-2219, or dmhc.ca.gov, for health plan denials and complaints.
Covered California: what your plan covers, including free preventive care.
MedlinePlus: free pages on sports injuries and sports safety.
Your own clinician: for physicals, clearance, and advice that fits your health.

Sources

Education Code section 49475 (concussion and head injury; school athletic programs) — California Public Law reproduction, last amended effective January 1, 2015; verified current October 26, 2026; accessed October 29, 2026.
Health and Safety Code section 124235 (youth sports organizations: concussion and sudden cardiac arrest) — California Public Law reproduction, text updated January 1, 2020; verified current October 19, 2026; accessed October 29, 2026.
Education Code section 35179.4 (written emergency action plan for interscholastic athletics) — California Public Law reproduction, text updated January 1, 2024; verified current September 14, 2026; accessed October 29, 2026.
AB 310, Nevaeh Youth Sports Safety Act, chaptered text (Chapter 254, Statutes of 2025) — California Legislature via LegiScan, approved October 3, 2025.
Concussions: CIF Member Schools Resources (Bylaw 503.H) — California Interscholastic Federation, accessed October 29, 2026.
Extreme Heat and Air Quality Policy, 2026-27 CIF Constitution and Bylaws (Bylaws 503.K and 503.L) — California Interscholastic Federation, posted by the CIF Southern Section, August 2026.
AB 2503 (Wallis), bill analysis — California Senate Committee on Education, hearing June 10, 2026.
Newsom signs law that could allow student athletes to play in higher temperatures — EdSource, 2026, accessed October 29, 2026.
California didn't raise its heat threshold for high school sports. Here's what actually changed — Healthy Roster, September 3, 2026.
Heat and Athletes — Centers for Disease Control and Prevention, last reviewed June 25, 2024.
Heat Acclimatization and Heat Illness Prevention position statement — National Federation of State High School Associations Sports Medicine Advisory Committee, revised October 2025.
Sudden Cardiac Arrest information and acknowledgment form — California Department of Education, updated April 2020.
Project Play survey: Family spending on youth sports rises 46% over five years — Aspen Institute Project Play, March 3, 2025.
Fact Sheet: Students with Disabilities in Extracurricular Athletics (Dear Colleague Letter) — U.S. Department of Education, Office for Civil Rights, January 25, 2013; and Disability Discrimination: Equal Access and Opportunities — U.S. Department of Education, last reviewed September 23, 2025.
Living with Paralysis: Adaptive Sports and Recreation — Christopher & Dana Reeve Foundation, 2022.
Sports Injuries — MedlinePlus, National Library of Medicine, updated September 22, 2025; and Sports Safety — MedlinePlus, National Library of Medicine, updated June 20, 2026.
4 tips for keeping young athletes safe — NIH MedlinePlus Magazine, September 15, 2021; and Sports injury? Finding a specialist can improve recovery — NIH MedlinePlus Magazine, September 30, 2021.
Head injury: first aid — MedlinePlus Medical Encyclopedia, reviewed October 14, 2025; and Broken bone — MedlinePlus Medical Encyclopedia, reviewed January 14, 2026; and Osgood-Schlatter disease — MedlinePlus Medical Encyclopedia, reviewed October 20, 2024.
City of Santa Barbara v. Superior Court (S141643) — Supreme Court of California, July 16, 2007, via Justia.
Free preventive care — Covered California, accessed October 29, 2026.
How to File a Complaint — California Department of Managed Health Care, accessed October 29, 2026.

Starting a sport safely, for adults and children