Mario has created his own version of tetris in order to challenge you. You should aim to get to the highest levels in order to show that you're Mario's number one fan.
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Use the right and left arrow keys to move the blocks. Press the up arrow key to change the position of a block; press the down arrow key to make a block fall more quickly. Form complete rows and the pieces will disappear, giving you points. Don't let the blocks accumulate or you'll lose. You'll get various bonus as you go along, depending on the number of rows you complete.