Mail Chimp Form Not Displaying

I just updated my theme to enable mail chimp intergration. I successfully authenticated via my api key. But when I add the mail chimp widget to my site configure it then preview nothing is displayed.

I thought it may be a caching issue as I am hosting on wpengine but I tried it on my staging server and the problem is still there.

I have also disabled all the plugins on my staging server as well. Problem remains.

I have included connection details in the private content section