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Secret 5th Character:
To unlock an extra fifth character, insert the GBA game Kirby and the Amazing Mirror (it doesnt seem to matter what region) into the DS and load up your save file on Kirby DS. A message will pop up and now the extra character will be available.

New characters to play in regular game and time trial/ink trial mode:
To unlock the first new character, Waddle Dee, beat the game once. He is exactly the same as Kirby except for the fact that he has four life and cannot obtain powers. The second new character, King Dee Dee Dee, is purchasable for 20 medals once you get Waddle Dee. He is large, has 7 life, and swings his hammer when you touch him. He cannot get powers either. The third new character is Metaknight. He is purchasable for 25 medals once you get King Dee Dee. He is almost twice as fast as Kirby and cannot get powers, but he only has 3 life. The game will keep track of what stages you beat with each character.

Alternative For Unlocking 5th Character:
An alternative way to unlock the 5th secret character is to complete the final level (Drawcia's Castle) while having the game "Kirby's Nightmare In Dream Land" (Region does not matter) inserted in the GBA slot in the Nintendo DS.

Unlock Waddle Dee:
Beat the game once.

Medal Swap Unlockables:
You need to get the appropriate amount of medals before you can unlock these in medal swap. Some of these cannot be unlocked until you meet certain requirements:

Bead Line - Six Medals
Course 1-8 - Nine Medals each
King Dedede - Twenty Medals
Life Boost - Seven Medals
Life Boost - Twelve Medals
Life Boost - Fourteen Medals
Meta Knight - Twenty-Five Medals
Song One - Three Medals
Song Three - Three Medals
Song Two - Three Medals
Tropic Line - Six Medals
Zebra Line - Six Medals

Easy Unlock Waddle Doo:
Normally, you would have to unlock Waddle Doo by beating the game with the other four balls. However, if you own a copy of Kirby: Nightmare in Dreamland or Kirby and the Amazing Mirror, place it in the GBA slot of your DS when you beat the game. The next file you load will have Waddle Doo unlocked.

Recharge paint supply in midair:
When you pick up a powerup that lets Kirby hover, such as Beam or Spark, hold Kirby in midair by pressing him with the stylus. He will hover until the stylus is removed, and the paint supply recharges while he hovers. This is useful for when Kirby is too high in the air to recharge normally.

Alternate title Screen:
When you beat the game 100%, when you load up the title screen it will be blue instead of the normal white.

Unlock Sound Test Tracks 24 and 40-44:
To unlock these six tracks of the end music, you have to beat the level World of Drawcia for the first time with Kirby. When you start up your file again, the new tracks are already added to the sound test.They are:24 - The World of Drawcia40 - Drawcia Demo41 - Dracia Sorceress42 - Drawcia Soul43 - Ending Cinema44 - Credits