Apply
There are 8 steps you need to follow to apply for one of our initiations. Click the cross if you have completed the step:
Step 1: Choose the type of initiation and which month you would like to receive the initiation. On this page you can also see if there is availability on that month. Max 5 people per initiation. Max 2 initiations per month.
Step 2: Prerequisites.
Make sure before you apply or pay for anything that you are in good health :)
- Heart Health: Heart QTc must be less than 450 ms in men and 460 ms in women. So do an ECG to make sure you have a healthy heart prior to the initiation (within 12 month)
- Liver health: Do a Liver Function Test (LFT) or hepatic panel test, to make sure your liver is healthy (valid within 12 month of the initiation).
- No drugs: 3 weeks prior and after the ceremony no drugs, this includes alcohol and pharmaceutical drugs of any kind.
- No supplemments: Take it easy with supplements and best not to take any prior to Gabon up to when you return. Pro-biotics and anti-malaria medication excluded, these are recommended.
Step 3: Options.
- Option 1: 11 days total - 2 days hotel Libreville, Mama Aline initiation only (8 days including food, drinks and rooms). Travel to our village and back including any hotel stops are all self-arrange. Airline back home directly after the initiation. See here how
- Option 2: 12 days total - 2 days hotel Libreville, Pickup by Jean Claude in Libreville. 8 days Mama Aline's initiation and after initiation a visit to Aboratum Raponda Walker park + option restaurant Chef O'Miel. See here how
- Option 3: Put your own program together and combine that with our initiation. Use one of the travel agents available in Gabon. See here how
Step 4: Apply for VISA 2 month prior to your arrival. Click here for your VISA application.
Make sure you have your VISA first before you travel to Gabon. So do not only apply but make sure all is ready upon arrival.
Step 7: The next step is copy paste the pre-initiation form below and send it to me via whatsapp or email.
You also need to print the pre-initiation form out, sign it and take it with you to Gabon.
Also bring your heart and liver test results with you. Once you are in our village we will collect them and do an interview with you.
Let me know what type of initiation and which month you would like to receive the initiation. I will email you back if this is possible and will try to include you into a group to reduce costs. However be aware that I might not respond for a couple of days, as this email is not checked every day.
Pre-Initiation Form
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Mama Aline Iboga ceremony pre-initiation form
We appreciate your cooperation in completing this form with utmost honesty and transparency. Mama Aline disclaims responsibility for any issues arising from omissions or inaccuracies in the provided information. Please disclose any undisclosed medical, pathological, or psychological conditions.
Personal Information
Name:
Surname:
Nationality:
Passport Number:
Date and Place of Birth:
Gender:
Height:
Weight:
Residential Address:
Contact Information
Country of Residence:
Telephone Number:
Email Address:
Emergency Contact Name:
Emergency Contact Email:
Emergency Contact Telephone:
Family Background
Father's Full Name:
Mother's Full Name:
Personal and Professional Details
Occupation/Profession:
Marital Status:
Number of Children (if any):
Languages and Interests
Languages Spoken:
Hobbies and Interests:
Iboga-Related Information
What has led you to Iboga?
Previous Iboga Usage (Quantity and Context):
Brief Description of Past Iboga Experience:
Initiation Intent and Previous Experiences
Reason for Seeking Initiation/Intention:
Previous Use of Entheogenic Plants (e.g., Ayahuasca, Peyote):
Health and Psychological Well-being
History of Traumatic Events that might be relevant to the ceremony:
Past Drug Usage (Types and Quantities):
Current Drug Usage (Types and Quantities):
Known Diseases (e.g., diabetes, hypertension, AIDS):
Medical History/Hospitalisations:
Current Medications or Treatments:
Self-Prescribed Medications, including herbs and supplements (if any):
Vaccination Status (Yellow Fever, Tetanus):
Allergies (if any):
History of Hospitalisation:
History of Psychological Care:
History of Suicidal Attempts (if any):
Psychiatric Disorders (if any):
Lifestyle and Travel
Dietary Requirements (e.g., Vegan, Pescetarian):
Gastrointestinal Issues (e.g., ulcers, constipation):
Sleep Disorders (if any):
Back Pain Issues (if any)
Travel History to Africa (Details):
Travel Difficulties Encountered (if any):
Concerns or Questions about the Stay:
Additional Comments or Information:
Iboga Ceremony Participation Agreement
This agreement is made on [Date] by and between [Participant's Full Name], herein referred to as "Participant", and Mama Aline, herein referred to as "Facilitator", for the Iboga Ceremony Retreat near Lambaréné, Gabon.
1. Acknowledgment of Risks
Participant acknowledges that they have voluntarily chosen to participate in the Iboga ceremony, a traditional spiritual retreat lasting 8 days, facilitated by Mama Aline. Participant understands that participating in an Iboga ceremony involves consumption of the Iboga plant, which is legal in Gabon but carries inherent risks including, but not limited to, physical and psychological effects.
2. Health and Safety
Participant affirms they have provided honest and complete answers to all health and personal inquiries provided by the Facilitator. Participant understands the importance of these disclosures for their safety and the safety of others in the retreat.
3. Personal Responsibility
Participant acknowledges that they are fully aware of the risks associated with Iboga consumption and the nature of the retreat. Participant agrees to assume full responsibility for any and all risks, injuries, or damages, known or unknown, which might incur as a result of participating in the retreat.
4. Release and Waiver of Liability
Participant hereby releases, waives, discharges, and covenants not to sue Mama Aline, her assistants, or any other participants for any liability, claims, demands, actions, and causes of actions whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by Participant, or to any property belonging to Participant, while participating in the Iboga ceremony or while on the premises where the event is taking place.
5. Indemnification
Participant agrees to indemnify and hold Mama Aline harmless from any loss, liability, damage, or costs, including court costs and attorney fees, that Mama Aline may incur due to Participant's participation in the Iboga ceremony.
6. Governing Law
This agreement shall be construed in accordance with, and governed by, the laws of Gabon and any disputes arising hereunder shall be subject to the exclusive jurisdiction of the courts of Gabon.
By signing below, Participant acknowledges having read and understood this agreement and accepts its terms and conditions in their entirety.
Participant's Signature: _______________________________
Date: _______________________________________________
Required Documents
Photo ID
ECG Test Result
Liver Panel Test Result