Jetpack Contact Form + Mailchimp opt-in?

Hi all,

I’m looking to build a contact form that has a mailchimp opt-in built in. I know Jetpack has MailChimp compatibility, and I know it has forms, but I don’t see a way to put the two together. I’d like to be able to build a page that looks something like this:

Name:

Email:

Comments:

Subscribe to our email list?

Right now, the only thing I can see is that I’d have to ask for the user’s email twice – once in the contact form, and then again in the MailChimp signup. Any way around this?

Thanks!