I need help with a PHP form.?

[curious]

Hey all, I have a new question for you guys! So I have this form:

<form action="" method="post">
<input name="1" type="checkbox" value="1"> <input name="1i" type="text"> <br />
<input name="2" type="checkbox" value="2"> <input name="2i" type="text"> <br />
<input name="3" type="checkbox" value="3"> <input name="3i" type="text"> <br />
<input name="4" type="checkbox" value="4"> <input name="4i" type="text"> <br />
<input name="5" type="checkbox" value="5"> <input name="5i" type="text"> <br />
<input name="6" type="checkbox" value="6"> <input name="6i" type="text"> <br />
<input name="7" type="checkbox" value="7"> <input name="7i" type="text"> <br />
<input name="8" type="checkbox" value="8"> <input name="8i" type="text"> <br />
<input name="9" type="checkbox" value="9"> <input name="9i" type="text"> <br />
<input name="email" type="text"> <br />
<input name="" type="submit">
</form>

And I want people to be able to enter in their own text and then check the checkbox off which will then somehow dim the text box and makes it un-editable but then if you re-check it, it will let you change the text.

I also want users to enter in their email address and have the form sent to them. Thanks for the help in advance!