Send XML SOAP request from HTML form

I am trying to send a SOAP request from a HTML form. My form has 6 fields as below:

City: -  text
Check-in - text/date
Check-Out - text/date
Rooms - Selector (1, 2, 3, 4, 5)
Adults - Selector (1, 2, 3, 4, 5)
Childs - Selector (0, 1, 2, 3, 4)

The cookies that i receive are

$In= $_POST['In'];
$Out= $_POST['Out'];
$City= $_POST['City'];
$Rooms= $_POST['Rooms'];
$Adults= $_POST['Adults'];
$Childs= $_POST['Childs'];

The response page have a SOAP client connection Example:

// create SOAP client object
  $client = new SoapClient("./book.wsdl", array('trace' => 1));
  try {
      $rooms = array();

      // request with 1 room and 2 adults selected
      $rooms[] = array(array("paxType" => "Adult"), array("paxType" => "Adult"));


      $filters = array();
      $filters[] = array("filterType" => "hotelStar", "filterValue" => "5");

      $filters[] = array("filterType" => "resultLimit", "filterValue" => "4");

      // make getAvailableHotel request (start search)
      $checkAvailability = $client->getAvailableHotel("3QXNHSXZRYUZOb095Qg==", "$City", "$In", "$Out", "EUR", "RO", "false", $rooms, $filters);

How can i translate the response from the form selector value into the request page as show below:

// request with 1 room and 2 adults selected

  $rooms[] = array(array("paxType" => "Adult"), array("paxType" => "Adult"));

Thanks.