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The player receives items and must cross a bridge of five turtles to deliver the items to the receiver on the other side of a lake. Each time the player delivers an item, they earn three points. On the way back to the home bank to grab the next item, the player earns from two to 12 extra points depending on how fast they return. However, the turtles at times will go down into the lake to eat fish, and if the player jumps onto or stays on a descending turtle, that player will fall into the lake and lose a life. Also, the player might need to wait for the receiver to appear and cannot return to the home bank while carrying an item. If the player reaches 200 or 500 points without any misses, then no fish will appear for the turtles for 20 to 40 seconds. If the player has any misses at either score, every miss will be cleared instead. The player receives a Game Over when they lose three lives.
In Game A, most fish appear to the left and right of the center turtle, and it does not descend unless the player stays on it too long. In Game B, however, fish will appear more frequently for the center turtle.
In the Modern version, the game stars Toad as the main character, who must deliver various items from Mario to Princess Peach. Unlike the original, this game does not take place in a lake but instead in the sky, as Toad is delivering the items from Mario's side of a castle to Peach's side of the castle, and rather than turtles, Toad crosses a bridge of flying Goonies to accomplish his task. Sometimes the Goonies will drop down to pop balloons that are floating up to the sky. If Toad is to jump onto or stay on a Goonie that is descending to pop a balloon, he will fall and lose a life. In this version, many elements from the Mario franchise were also added, such as coins that remain suspended in the air and reward Toad with extra points if he collects them. As long as Toad delivers an item without losing a life, Mario will give him a different item worth a few more points over time. Delivering a Mushroom gives Toad six points; a Yoshi Egg, eight points; a present, 10 points; a Melon, 12 points; and a Super Star, 15 points. Additionally, there is a platform in the middle that changes over time. At 300 points, a three-second countdown timer gets added to the platform, which makes it fall after the timer hits zero. At 600 points, the platform turns into two Donut Blocks, which fall shortly after Toad lands on them. Toad also loses a life if he jumps onto or stays on a descending platform. At 200, 500, and 700 points, a Lakitu will appear and drop a Heart for Toad to remove a miss. Unlike the Classic version, music is featured, with the tempo changing depending on the speed of the game.