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Nevermind, figured it out! It's in the itch\apps\tanglewood\bin directory. I just renamed the extension from .BIN to .MD (which may not be necessary, but I didn't realize ROMs came in a BIN format).

Hmmm....  When I hit ESC I get a menu, but none of the buttons lead me to extract the ROM.

I checked the installed folder but can't find it. Can't find any mention of it in the instructions. I'd like to play it on my Genesis using a flash cart.